Provider Demographics
NPI:1407881071
Name:NORDSTROM INC
Entity Type:Organization
Organization Name:NORDSTROM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHESIS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCK-KIRIHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-373-2047
Mailing Address - Street 1:1617 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:693 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-7783
Practice Address - Country:US
Practice Address - Phone:801-426-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT0435530090Medicare NSC