Organization
STAT MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ANTHONY CONFORTO (PRESIDENT/CEO)
(206) 621-1982
Entity
Organization
Contact information
Practice address
3411 FRUITVALE BLVD, YAKIMA, WA 98902-7320
(509) 972-3989
(509) 972-4494
Mailing address
21222 30TH DR SE, SUITE 210, BOTHELL, WA 98021-7069
(206) 621-1982
(425) 820-0831
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6012058040010003
WA
332BC3200X
Customized Equipment (DME)
6012058040010003
WA
332BN1400X
Nursing Facility Supplies (DME)
6012058040010003
WA
332BX2000X
Oxygen Equipment & Supplies (DME)
6012058040010003
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066134
LABOR & INDUSTRIES
WA
05
—
9029265
—
WA
05
—
9038860
—
WA
05
—
9047085
—
WA
01
—
ST2365
REGENCE BLUE SHIELD
WA
Enumeration date
05/10/2006
Last updated
08/21/2008
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