Provider Demographics
NPI:1316138654
Name:KAIDE, LLOYD (CPO)
Entity type:Individual
Prefix:
First Name:LLOYD
Middle Name:
Last Name:KAIDE
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4928
Mailing Address - Country:US
Mailing Address - Phone:425-353-5385
Mailing Address - Fax:425-348-9535
Practice Address - Street 1:4009 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4928
Practice Address - Country:US
Practice Address - Phone:425-252-5309
Practice Address - Fax:425-252-8745
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOI00000039222Z00000X
WAPS00000040224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist