Healthcare Provider Details

I. General information

NPI: 1194902155
Provider Name (Legal Business Name): CHELSEY A PULLMAN CPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-8448
  • Fax: 206-987-8449
Mailing address:
  • Phone: 206-987-8448
  • Fax: 206-987-8449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberPS60070337
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberOI00000482
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: