Organization
VIRGINIAS FEMININE BOUTIQUE, LLC
Active
Other names
Virginia Lee Shipp
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN SHIPP (OFFICE MANAGER)
(360) 659-7928
Entity
Organization
Contact information
Practice address
3627 152ND ST NE, MARYSVILLE, WA 98271-8944
(360) 659-7928
(360) 658-7178
Mailing address
PO BOX 3768, ARLINGTON, WA 98223-0800
(360) 659-7928
(360) 658-7178
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097172001
GROUP HEALTH
WA
01
—
130242
LABOR & INDUSTRIES
WA
05
—
9062472
—
WA
Enumeration date
10/27/2006
Last updated
08/29/2009
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