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General NPI Number Information
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NPI Number | 1912522053
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Entity Type | Organization
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Legal Business Name | DURABLE MEDICAL EQUIPMENT LLC
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 9909 168TH ST E STE 102
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City | PUYALLUP
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State | WA
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Zip | 98375-2513
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Country | US
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Telephone | 253-961-6880
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Fax | 888-856-3201
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Provider Business Mailing Address
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Address Line | 9909 168TH ST E STE 102
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City | PUYALLUP
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State | WA
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Zip | 98375-2513
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Country | US
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Telephone | 253-961-6880
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON NORDQUIST
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Credential | DC
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Telephone | 253-961-6880
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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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Taxonomy #2
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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 |
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