Healthcare Provider Details

I. General information

NPI: 1902458821
Provider Name (Legal Business Name): KIERRA JEAN FALBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 EASTLAKE AVE E STE 300
SEATTLE WA
98109-5546
US

IV. Provider business mailing address

2501 E MADISON ST APT 202
SEATTLE WA
98112-4753
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax: 206-598-4726
Mailing address:
  • Phone: 724-678-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: