Provider Demographics
NPI:1922283761
Name:NORTH AMERICAN MEDICAL
Entity Type:Organization
Organization Name:NORTH AMERICAN MEDICAL
Other - Org Name:NORTH AMERICAN REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-845-6050
Mailing Address - Street 1:4616 25TH AVE NE
Mailing Address - Street 2:#293
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4183
Mailing Address - Country:US
Mailing Address - Phone:800-845-6050
Mailing Address - Fax:253-572-3723
Practice Address - Street 1:2817 NE 55TH ST
Practice Address - Street 2:STE F
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5529
Practice Address - Country:US
Practice Address - Phone:800-845-6050
Practice Address - Fax:253-572-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602722582332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1055203Medicaid