| NPI | 1770644353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN A HALL Owner/President 360-607-8757 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA 211003611) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: WA 211003611) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: WA 211003611) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2011-06-23 |