Basic Information
| Provider Information | |||||||||
| NPI: | 1285656256 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHWEST HAND THERAPY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 97115 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984970115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535887911 | ||||||||
| FaxNumber: | 2539846774 | ||||||||
| Practice Location | |||||||||
| Address1: | 2820 GRIFFIN AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | ENUMCLAW | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980222373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608026838 | ||||||||
| FaxNumber: | 3608026839 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 05/02/2013 | ||||||||
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| AuthorizedOfficialLastName: | LOUIE | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3608026838 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | OT00002354 | WA | N | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | 174400000X | OT00002354 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.