| NPI | 1982053880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LINDSLEY CEO 360-771-4826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2021-08-25 |