Provider Demographics
NPI:1699989210
Name:NORTHWEST HAND THERAPY
Entity type:Organization
Organization Name:NORTHWEST HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:360-802-6838
Mailing Address - Street 1:2820 GRIFFIN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-2373
Mailing Address - Country:US
Mailing Address - Phone:360-802-6838
Mailing Address - Fax:360-802-6839
Practice Address - Street 1:2820 GRIFFIN AVE STE 210
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2373
Practice Address - Country:US
Practice Address - Phone:360-802-6838
Practice Address - Fax:360-802-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002354332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4749320001OtherDMERC
WAS93338Medicare UPIN
WA8800438Medicare PIN