Active NPI
Seattle Orthotics and Prosthetics, LLC
- Prosthetic/Orthotic Supplier
- Puyallup, WA
National Provider Identifier
1043765878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- PS00000071
- Legal business name
- SEATTLE ORTHOTICS AND PROSTHETICS, LLC
- Practice address
- 120 14TH Ave SE
Suite D
Puyallup, WA 98372-3718 - Phone
- (253) 848-0128
- Fax
- (206) 299-9445
- NPI assigned
- Aug 22, 2016
- Organization subpart
- Yes
- Parent organization
- SEATTLE ORTHOTICS AND PROSTHETICS,LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Ellis Hensley, LCPO
- Title
- Owner
- Phone
- (425) 640-2004
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | PS00000071 | WA | Primary |
Addresses
Primary practice location
120 14TH Ave SE
Suite D
Puyallup, WA 98372-3718
Mailing address
6405 218TH St SW
Suite 304
Mountlake Terrace, WA 98043-2180
Phone (425) 640-2004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669896973 | Other | WA | NPI |
Other names 1
- Valley Prosthetics and Orthotics, LLC
National Provider Directory
National Provider Directory- Part of
- Seattle Orthotics and Prosthetics LLC
Locations
120 14th Ave SE
Ste D
Puyallup, WA 98372
Phone (253) 200-2144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1473897600000",
"number": "1043765878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6405 218TH ST SW",
"address_2": "SUITE 304",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980432180",
"telephone_number": "425-640-2004",
"fax_number": "206-299-9445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 14TH AVE SE",
"address_2": "SUITE D",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723718",
"telephone_number": "253-848-0128",
"fax_number": "206-299-9445"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SEATTLE ORTHOTICS AND PROSTHETICS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SEATTLE ORTHOTICS AND PROSTHETICS,LLC",
"enumeration_date": "2016-08-22",
"last_updated": "2016-09-15",
"status": "A",
"authorized_official_last_name": "HENSLEY",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "ELLIS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "425-640-2004",
"authorized_official_credential": "LCPO"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "WA",
"license": "PS00000071",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1669896973",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Valley Prosthetics and Orthotics, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.