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General NPI Number Information
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NPI Number | 1669896973
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Entity Type | Organization
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Legal Business Name | SEATTLE ORTHOTICS AND PROSTHETICS
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 6405 218TH ST SW SUITE 304
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2180
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Country | US
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Telephone | 425-620-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 120 14TH AVE SE SUITE D
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City | PUYALLUP
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State | WA
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Zip | 98372-3718
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Country | US
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Telephone | 253-840-0606
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID E HENSLEY
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Credential | CPO
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Telephone | 253-840-0606
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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 | PS00000071
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License Number State | WA
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