Healthcare Provider Details

I. General information

NPI: 1528336138
Provider Name (Legal Business Name): PERFORMANCE MODALITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18100 NE UNION HILL RD STE 305
REDMOND WA
98052-3330
US

IV. Provider business mailing address

19625 62ND AVE., S SUITE A101
KENT WA
98032-1106
US

V. Phone/Fax

Practice location:
  • Phone: 425-881-8072
  • Fax: 425-881-8074
Mailing address:
  • Phone: 253-852-5612
  • Fax: 253-852-0427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: LUANA MICHELE HALL
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 206-569-4601