Provider Demographics
NPI:1255743431
Name:BATH PLUS INC
Entity type:Organization
Organization Name:BATH PLUS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:O
Authorized Official - Last Name:SARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-941-2258
Mailing Address - Street 1:1427 130TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2221
Mailing Address - Country:US
Mailing Address - Phone:425-941-2258
Mailing Address - Fax:
Practice Address - Street 1:2719 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4527
Practice Address - Country:US
Practice Address - Phone:425-941-2258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABATHPPI908Q4332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA951667Medicaid