| NPI | 1487148847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTEN M EADS Clinic Admin/CFO 360-447-0770 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X (Licence: WA OI00000067) |
| 224P00000X Prosthetist (Licence: WA PS00000068) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2021-09-14 |