Maughan Prosthetic & Orthotic, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MAUGHAN PROSTHETIC & ORTHOTIC, INC.

Practice address

127 SW 156TH St
Burien, WA 98166

Phone

(206) 246-2714

Fax

(206) 246-4665

NPI assigned

Jun 19, 2018

Last updated

Sep 14, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MAUGHAN PROSTHETIC & ORTHOTIC, INC.As reported in NPPES

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

Authorized official

Name

Krysten M Eads

Title

Clinic Admin/Cfo

Phone

(360) 447-0770

Specialties & licenses 3

Addresses

Other identifiers 1

Part of

Maughan Prosthetic Orthotic Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Maughan Prosthetic & Orthotic, Inc.

  • Prosthetic/Orthotic Supplier
  • Silverdale, WA
  • NPI 1215168398
  NPPES parent name

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1487148847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1546",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983381546",
            "telephone_number": "360-447-0770",
            "fax_number": "253-904-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SW 156TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98166",
            "telephone_number": "206-246-2714",
            "fax_number": "206-246-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUGHAN PROSTHETIC & ORTHOTIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAUGHAN PROSTHETIC & ORTHOTIC, INC.",
        "enumeration_date": "2018-06-19",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "EADS",
        "authorized_official_first_name": "KRYSTEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC ADMIN/CFO",
        "authorized_official_telephone_number": "360-447-0770"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "WA",
            "license": "OI00000067",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "WA",
            "license": "PS00000068",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007326",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Masterson
• Allison L Mastrangelo
• Shirley Matenda, RD
• Tiffany E Mathis
• Matthew Tomala DDS MSD PLLC
• Peter F Maurice III, M.D.
• Mindy Maxwell
• Ana Caren Maya Arteaga
• Viktor N Mazurets, DDS
• Eliane Marilyne Mbonde, LPN

• 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 Sep 14, 2021; 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.