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General NPI Number Information
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NPI Number | 1558641886
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Entity Type | Organization
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Legal Business Name | PROSTHETIC SPECIALISTS OF WASHINGTON
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 11417 124TH AVE NE STE 103
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City | KIRKLAND
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State | WA
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Zip | 98033-4677
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Country | US
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Telephone | 425-576-5050
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Fax | 206-202-0866
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Provider Business Mailing Address
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Address Line | 7047 17TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98117-5551
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Country | US
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Telephone | 425-576-5050
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Fax | 206-202-0866
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Authorized Official
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Title or Position | OWNER
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Name | MR. SANJAY KUMAR PERTI
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Credential | CPO
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Telephone | 425-576-5050
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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 |
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License Number State |
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