=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114393345
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JANALAIR LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2015
-----------------------------------------------------
Last Update Date | 02/02/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7942 NOBLE VIEW LN NW
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98502-9629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-791-2207
-----------------------------------------------------
Fax | 888-570-2341
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7942 NOBLE VIEW LN NW
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98502-9629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-791-2207
-----------------------------------------------------
Fax | 888-570-2341
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AO/AM, CPO, OWNER
-----------------------------------------------------
Name | JAN ALAIR THOMPSON
-----------------------------------------------------
Credential | CPO, LPO
-----------------------------------------------------
Telephone | 360-791-2207
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------