Provider Demographics
NPI:1386722577
Name:WHEN THE SHOE FITS, LLC
Entity type:Organization
Organization Name:WHEN THE SHOE FITS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HARA
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:360-882-8962
Mailing Address - Street 1:819 SE 160TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9668
Mailing Address - Country:US
Mailing Address - Phone:360-882-8962
Mailing Address - Fax:360-882-8172
Practice Address - Street 1:819 SE 160TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9668
Practice Address - Country:US
Practice Address - Phone:360-882-8962
Practice Address - Fax:360-882-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9659 (BCP #)332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5321400001Medicare ID - Type Unspecified