=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275457467
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINDFORMAT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2026
-----------------------------------------------------
Last Update Date | 08/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1036 FOWLER ST
-----------------------------------------------------
City | RAYMOND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98577-4615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-761-4443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 257 PMB 09182
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98507-0257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-761-4443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SHARLA GEORGE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 509-761-4443
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------