Pacific Prosthetics and Orthotics, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PS000000555555 Issued in WA

Legal business name

PACIFIC PROSTHETICS AND ORTHOTICS, LLC

Practice address

322 SW 155TH St
Suite C
Burien, WA 98166-2590

Phone

(206) 246-8910

Fax

(206) 242-0165

NPI assigned

Nov 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Raymond M Frieszell, CPO

Title

Owner

Phone

(206) 246-8910

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Choi, MD

  • Family Medicine Physician
  • Burien, WA
  • NPI 1902840382
  NPD (past)
• Whitney D Hogan, NP

  • Nurse Practitioner
  • Burien, WA
  • NPI 1851899041
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1316018583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 64TH AVENUE CT E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984241479",
            "telephone_number": "206-246-8910",
            "fax_number": "253-927-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SW 155TH ST",
            "address_2": "SUITE C",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662590",
            "telephone_number": "206-246-8910",
            "fax_number": "206-242-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PROSTHETICS AND ORTHOTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "FRIESZELL",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-246-8910",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "PS000000555555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9049644",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "2020PA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "139008",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Jan Ovalles
• Naya Simone Owusu, AUD
• Teresita J Pablo, PHARMACIST
• Pacific Clinic & Urgent Care PLLC
• Pacific Medical, Inc.
• Sodaba Pahlavi
• Pain Science Physical Therapy
• Monica Pal, PHARMD
• Melissa Pangborn
• Bibek Singh Pannu, MD

• Prosthetic/Orthotic Supplier in Burien, WA
• Providers in Burien, WA by specialty
• Prosthetic/Orthotic Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.