Provider Demographics
NPI:1598090565
Name:HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Entity Type:Organization
Organization Name:HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:1655 S MARKET BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3826
Mailing Address - Country:US
Mailing Address - Phone:360-748-3412
Mailing Address - Fax:360-740-8034
Practice Address - Street 1:1655 S MARKET BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3826
Practice Address - Country:US
Practice Address - Phone:360-748-3412
Practice Address - Fax:360-740-8034
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-08
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0340220228Medicare NSC