| NPI | 1295042299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA MATTESON Office Manager 360-253-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2010-09-12 |
| Last Update Date | 2014-01-08 |