Healthcare Provider Details

I. General information

NPI: 1609978451
Provider Name (Legal Business Name): MR. DONALD L FELTHOUSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A-112-BRC BLIND REHABILITATION CTR AMERICAN LAKE VA
TACOMA WA
98493-0001
US

IV. Provider business mailing address

A-112-BRC BLIND REHABILITATION CTR AMERICAN LAKE VA
TACOMA WA
98493-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-583-1221
  • Fax: 253-589-4112
Mailing address:
  • Phone: 253-583-1221
  • Fax: 253-589-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: