| NPI | 1306226170 |
|---|---|
| Doing Business As | OPTUM NORTHGATE PLAZA |
| Entity Type | Organization |
| Authorized Contact | CRAIG PEPIN Physician/Owner 206-860-5414 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251H1200X Physical Therapist Hand | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2024-08-12 |