Provider Demographics
NPI:1912920448
Name:1ST MEDICAL
Entity Type:Organization
Organization Name:1ST MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CALE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-302-7220
Mailing Address - Street 1:1404 E YESLER WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5516
Mailing Address - Country:US
Mailing Address - Phone:206-302-7220
Mailing Address - Fax:206-302-7221
Practice Address - Street 1:1404 E YESLER WAY STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5516
Practice Address - Country:US
Practice Address - Phone:206-302-7220
Practice Address - Fax:206-302-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5750820001Medicare NSC