Healthcare Provider Details

I. General information

NPI: 1003252057
Provider Name (Legal Business Name): JOSEPH N STERNARD CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34709 9TH AVE S SUITE A-100
FEDERAL WAY WA
98003-8722
US

IV. Provider business mailing address

1901 S CEDAR ST SUITE 101
TACOMA WA
98405-2308
US

V. Phone/Fax

Practice location:
  • Phone: 253-952-3887
  • Fax: 253-927-3058
Mailing address:
  • Phone: 253-572-1282
  • Fax: 253-572-1175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberOI60341122
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberPS60464607
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: