Provider Demographics
NPI:1912081860
Name:AMERICAN ARTIFICIAL LIMB CO
Entity Type:Organization
Organization Name:AMERICAN ARTIFICIAL LIMB CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:LPO, CPO
Authorized Official - Phone:206-324-1222
Mailing Address - Street 1:650 S ORCAS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-2654
Mailing Address - Country:US
Mailing Address - Phone:206-324-1222
Mailing Address - Fax:206-324-0070
Practice Address - Street 1:650 S ORCAS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-2654
Practice Address - Country:US
Practice Address - Phone:206-324-1222
Practice Address - Fax:206-324-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0100000369222Z00000X
WAPS00000350224P00000X
WA600104700335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA191646100OtherACS
WA9266701Medicaid
WA256250001Medicare UPIN
WA0256250001Medicare UPIN