Eastside Mobility, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6026137881 Issued in WA

Legal business name

EASTSIDE MOBILITY, LLC

Practice address

4921 370TH CT SE
Fall City, WA 98024-9721

Phone

(425) 241-0149

NPI assigned

May 27, 2008

Organization subpart

No

Name

Sophie B Harris

Title

Owner

Phone

(425) 241-0149

• Eastside Mobility Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 27, 2008.

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1760640726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "FALL CITY",
            "state": "WA",
            "postal_code": "980241325",
            "telephone_number": "425-241-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 370TH CT SE",
            "city": "FALL CITY",
            "state": "WA",
            "postal_code": "980249721",
            "telephone_number": "425-241-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE MOBILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "SOPHIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-241-0149"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "6026137881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTOPN DEPARTMENT OF LABOR AND INDUSTRIES",
            "identifier": "0213921",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Mobility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Justin David Copeland, D.C.
• Paige Anne Coslett
• Jennifer Leigh Dalgleish
• Louise Christine Gabrielle Derksen, COTA/L
• Drew Senior Services
• McKayla Fahlenkamp
• Fall City Dental Clinic Inc
• Gregory Manning Fawcett, D.D.S.
• Sabra Serrin Fawcett, D.D.S.
• Merritt Elizabeth Glennon, LMHCA

• All providers in Fall City, WA
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.