NPIMap

Organization Active NPI

West Coast Prosthetics and Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Aberdeen, WA
National Provider Identifier
1265590012
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
602115813 Issued in WA
Legal business name
WEST COAST PROSTHETICS AND ORTHOTICS, LLC
Practice address
611 N F St
Aberdeen, WA 98520-2667
Phone
(360) 533-7025
Fax
(360) 533-5604
NPI assigned
Dec 5, 2006
Last updated
May 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dale E Anderson, LCPONPI 1285695007
Title
Managing Member
Phone
(360) 956-3333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 602115813 WA Primary

Addresses

Primary practice location

611 N F St
Aberdeen, WA 98520-2667

Mailing address

PO Box 1994
Olympia, WA 98507-1994
Phone (360) 956-3333

Other identifiers 1

IdentifierTypeStateIssuer
9051483MedicaidWA

National Provider Directory

National Provider Directory

Locations

611 N F St
Aberdeen, WA 98520
Phone (360) 533-7025

2102 Carriage St SW
Ste 102
Olympia, WA 98502
Phone (360) 956-3333

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1265590012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1994",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985071994",
            "telephone_number": "360-956-3333",
            "fax_number": "360-956-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N F ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985202667",
            "telephone_number": "360-533-7025",
            "fax_number": "360-533-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST PROSTHETICS AND ORTHOTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "360-956-3333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "602115813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9051483",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.