Healthcare Provider Details

I. General information

NPI: 1275457467
Provider Name (Legal Business Name): KINDFORMAT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 FOWLER ST
RAYMOND WA
98577-4615
US

IV. Provider business mailing address

PO BOX 257 PMB 09182
OLYMPIA WA
98507-0257
US

V. Phone/Fax

Practice location:
  • Phone: 509-761-4443
  • Fax:
Mailing address:
  • Phone: 509-761-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHARLA GEORGE
Title or Position: CEO
Credential:
Phone: 509-761-4443