Organization
MAUGHAN PROSTHETIC & ORTHOTIC, INC.
Active
Parent organization
MAUGHAN PROSTHETIC & ORTHOTIC, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAUGHAN PROSTHETIC & ORTHOTIC, INC.
Authorized official
KRYSTEN M EADS (CLINIC ADMIN/CFO)
(360) 447-0770
Entity
Organization
Contact information
Practice address
127 SW 156TH ST, BURIEN, WA 98166
(206) 246-2714
(206) 246-4665
Mailing address
PO BOX 1546, GRAHAM, WA 98338-1546
(360) 447-0770
(253) 904-8705
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000067
WA
224P00000X
Prosthetist
PS00000068
WA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2007326
—
WA
Enumeration date
06/19/2018
Last updated
09/14/2021
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