Healthcare Provider Details

I. General information

NPI: 1063906295
Provider Name (Legal Business Name): WMC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 3RD AVE STE B
SEATTLE WA
98121-1293
US

IV. Provider business mailing address

2600 3RD AVE STE B
SEATTLE WA
98121-1293
US

V. Phone/Fax

Practice location:
  • Phone: 206-441-3242
  • Fax: 206-956-0987
Mailing address:
  • Phone: 206-441-3242
  • Fax: 206-956-0987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number601415811
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number601415811
License Number StateWA

VIII. Authorized Official

Name: JUDI WYGANT-COLLIER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 206-441-3242