Provider Demographics
NPI:1699959155
Name:TERRAPIN TECHNOLOGIES, INC
Entity type:Organization
Organization Name:TERRAPIN TECHNOLOGIES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DALILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINER
Authorized Official - Suffix:
Authorized Official - Credentials:BOC
Authorized Official - Phone:310-212-3067
Mailing Address - Street 1:129 N 85TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3601
Mailing Address - Country:US
Mailing Address - Phone:206-706-2573
Mailing Address - Fax:
Practice Address - Street 1:129 N 85TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3601
Practice Address - Country:US
Practice Address - Phone:206-706-2573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TERRAPIN TECHNOLOGIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ62594ZOtherBLUE CROSS
CA4590610001Medicare NSC