| NPI | 1073608733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN J WALETICH Owner 360-726-6928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WA 601 544 278) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: WA 601 544 278) |
| 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies (Licence: WA 601 544 278) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-06-10 |