Provider Demographics
NPI:1295911998
Name:NORDSTROM INC & SUBSIDIARIES
Entity type:Organization
Organization Name:NORDSTROM INC & SUBSIDIARIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIISA
Authorized Official - Middle Name:
Authorized Official - Last Name:THORSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-804-1502
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:206-373-2047
Mailing Address - Fax:206-373-2008
Practice Address - Street 1:19507 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-356-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORDSTROM INC & SUBSIDIARIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-14
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0435530110Medicare NSC