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General NPI Number Information
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NPI Number | 1912336025
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Entity Type | Organization
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Legal Business Name | CENTER FOR PROSTHETICS ORTHOTICS, INC.
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 411 12TH AVE SUITE 200
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City | SEATTLE
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State | WA
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Zip | 98122-5599
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Country | US
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Telephone | 206-328-4276
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Fax |
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Provider Business Mailing Address
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Address Line | 411 12TH AVE SUITE 200
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City | SEATTLE
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State | WA
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Zip | 98122-5599
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Country | US
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Telephone | 206-328-4276
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSE E IGNACIO
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Credential | LCPO
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Telephone | 206-328-4276
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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 | PS 60414610
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License Number State | WA
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