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General NPI Number Information
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NPI Number | 1427952613
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Entity Type | Organization
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Legal Business Name | MATTICE BEAUTY SUPPLY
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 3906 S 12TH ST UNIT A
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City | TACOMA
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State | WA
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Zip | 98405-1507
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Country | US
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Telephone | 253-327-1147
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 S 12TH ST UNIT A
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City | TACOMA
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State | WA
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Zip | 98405-1507
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Country | US
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Telephone | 253-327-1147
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVIDA SHARPE
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Credential |
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Telephone | 253-327-1147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NULL
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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 |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State | NULL
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