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NPI Code Detail

MEDICARE: COSTCO WHOLESALE CORPORATION

MEDICARE: COSTCO WHOLESALE CORPORATION
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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1871983411
Entity Type Code : Organization
Provider Name (Legal Business Name) : COSTCO WHOLESALE CORPORATION
Provider Business Mailing Address
First Line : PO BOX 35005
Second Line :
City : SEATTLE
State : WA
Zip : 98124-3405
Country : US
Telephone Number : 425-313-8100
Fax Number : 425-313-6922
Provider Business Practice Location Address
First Line : 4849 NE 138TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97230-3401
Country : US
Telephone Number : 503-252-2243
Fax Number : 503-258-3722
Authorized Official
Title or Position : AVP OPTICAL
Name : ART SALAS
Credential :
Telephone Number : 503-258-3727
Provider Enumeration Date : 02/04/2015
Last Update Date : 02/20/2020

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Directions to “COSTCO WHOLESALE CORPORATION ” Practice Location

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