Provider Demographics
NPI:1881916450
Name:INSPIRE MEDICAL CLINIC INC.
Entity type:Organization
Organization Name:INSPIRE MEDICAL CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-683-8783
Mailing Address - Street 1:1400 W WASHINGTON ST
Mailing Address - Street 2:# 104
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3236
Mailing Address - Country:US
Mailing Address - Phone:360-683-8783
Mailing Address - Fax:
Practice Address - Street 1:1400 W WASHINGTON ST
Practice Address - Street 2:#104
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3236
Practice Address - Country:US
Practice Address - Phone:360-683-8783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABUSLIC01471261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty