MEDICARE: PROFESSIONAL MEDICAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679572036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL MEDICAL CORP

Provider Business Mailing Address
First Line	:	PO BOX 15112
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-0112
Country	:	US
Telephone Number	:	206-366-9543
Fax Number	:	206-366-9544

Provider Business Practice Location Address
First Line	:	12733 28TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4321
Country	:	US
Telephone Number	:	206-366-9543
Fax Number	:	206-366-9544

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. FRUMI L MARASOW
Credential	:
Telephone Number	:	206-366-9543

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	03/24/2008

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Directions to “PROFESSIONAL MEDICAL CORP ” Practice Location

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