Custom Prosthetic, LTD.

Primary specialty

AnaplastologistTaxonomy code 229N00000X

Legal business name

CUSTOM PROSTHETIC, LTD.

Practice address

705 Opera Aly Ste K
Tacoma, WA 98402-3734

Phone

(253) 327-1924

Fax

(206) 826-1790

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Sharon A Haggerty, M.A.M.S.

Title

President, Anaplastologist

Phone

(253) 327-6192

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1710008537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 OPERA ALY STE K",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023734",
            "telephone_number": "253-327-1924",
            "fax_number": "206-826-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 OPERA ALY STE K",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023734",
            "telephone_number": "253-327-1924",
            "fax_number": "206-826-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM PROSTHETIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "HAGGERTY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT, ANAPLASTOLOGIST",
        "authorized_official_telephone_number": "253-327-6192",
        "authorized_official_credential": "M.A.M.S."
    },
    "taxonomies": [
        {
            "code": "229N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anaplastologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9044017",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0170345",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Cushman
• Howard M. Cushner, M.D.
• Christina Cusolito, LMHC
• Jonathan Lee Custer
• Elizabeth Rosemund Custodio
• Katy Marie Cutler
• Angelina Cutright
• Mary Gene Paglinawan Cuyugan, MD
• CW Counseling Services, PLLC
• Adrienne A. Cygnar, MD

• Anaplastologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Anaplastologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.