Provider Demographics
NPI:1164152898
Name:PERFORMANCE MODALITIES INC.
Entity Type:Organization
Organization Name:PERFORMANCE MODALITIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:LUANA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-569-4601
Mailing Address - Street 1:19625 62ND AVE S STE A101
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-1106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11790 SW BARNES RD STE 360
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5935
Practice Address - Country:US
Practice Address - Phone:866-687-4463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies