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General NPI Number Information
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NPI Number | 1023218831
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Entity Type | Organization
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Legal Business Name | CENTER FOR PROSTHETICS ORTHOTICS, INC.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 411 12TH AVE
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City | SEATTLE
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State | WA
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Zip | 98122-5577
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Country | US
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Telephone | 206-328-4276
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Fax | 206-328-1037
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Provider Business Mailing Address
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Address Line | 411 12TH AVE
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City | SEATTLE
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State | WA
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Zip | 98122-5577
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Country | US
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Telephone | 206-328-4276
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Fax | 206-328-1037
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID VARNAU
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Credential | C.P.O., L.P.O.
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Telephone | 206-328-4276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 0100000010
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | PS00000011
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License Number State | WA
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