Provider Demographics
NPI:1528154572
Name:NORDSTROM INC & SUBSIDIARIES
Entity type:Organization
Organization Name:NORDSTROM INC & SUBSIDIARIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROSTHESIS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRESHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-454-4060
Mailing Address - Street 1:1617 6TH AVE
Mailing Address - Street 2:ATTN: PROSTHESIS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1707
Mailing Address - Country:US
Mailing Address - Phone:206-454-4060
Mailing Address - Fax:
Practice Address - Street 1:6191 S STATE ST STE 200
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7265
Practice Address - Country:US
Practice Address - Phone:801-261-4402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT0435530056Medicare NSC