Provider Demographics
NPI:1003911702
Name:HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Entity Type:Organization
Organization Name:HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Other - Org Name:HANGER CLNIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REG COMPLIANCE SPECIALIST III
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-961-2102
Mailing Address - Street 1:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:206-323-4040
Mailing Address - Fax:206-625-4741
Practice Address - Street 1:1101 MADISON ST STE 550
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1320
Practice Address - Country:US
Practice Address - Phone:206-323-4040
Practice Address - Fax:206-625-4741
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-14
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0340220200Medicare NSC