Organization Active NPI

Kleenwell Medical Service

  • Durable Medical Equipment & Medical Supplies
  • Burien, WA
National Provider Identifier
1417178559
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KLEENWELL MEDICAL SERVICE
Practice address
15411 4TH Ave SW
Suite B
Burien, WA 98166-2571
Phone
(206) 433-0715
Fax
(206) 241-0370
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Mari Jo Rowland, DME
Title
Authorized Official
Phone
(206) 433-0715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

15411 4TH Ave SW
Suite B
Burien, WA 98166-2571

Mailing address

15411 4TH Ave SW
Suite B
Burien, WA 98166-2571
Phone (206) 433-0715

Other identifiers 1

IdentifierTypeStateIssuer
9037789MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417178559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15411 4TH AVE SW",
            "address_2": "SUITE B",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662571",
            "telephone_number": "206-433-0715",
            "fax_number": "206-241-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15411 4TH AVE SW",
            "address_2": "SUITE B",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662571",
            "telephone_number": "206-433-0715",
            "fax_number": "206-241-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEENWELL MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "MARI",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "206-433-0715",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DME"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9037789",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.