Organization
ORTHOCARE INNOVATIONS CLINICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE K DALY C.P.O., L.P.O., F.A. (RESEARCH PROSTHETIST)
(425) 771-0797
Entity
Organization
Contact information
Practice address
6405 218TH SW, SUITE 301, MOUNTLAKE TERRACE, WA 98043-2180
(425) 771-0797
(206) 219-1144
Mailing address
6405 218TH S.W., SUITE 301, MOUNTLAKE TERRACE, WA 98043-2180
(425) 771-0797
(206) 219-1144
Taxonomy
Speciality
Code
Description
License number
State
261QA0900X
Amputee Clinic/Center
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6346080001
CMS PTAN NUMBER
WA
Enumeration date
07/10/2009
Last updated
02/19/2014
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