Healthcare Provider Details
I. General information
NPI: 1316198815
Provider Name (Legal Business Name): WAYNE BIGGS CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US
IV. Provider business mailing address
1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US
V. Phone/Fax
- Phone: 206-277-6951
- Fax: 206-277-6429
- Phone: 206-277-6951
- Fax: 206-277-6429
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 222Z00000X |
| Taxonomy | Orthotist |
| License Number | OI439 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | PS423 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: