Organization
PERFORMANCE MODALITIES INC
Active
Other names
Performance Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
LUANA MICHELE HALL NAC (DIRECTOR OF COMPLIANCE)
(206) 569-4601
Entity
Organization
Contact information
Practice address
1498 SE TECH CENTER PLACE, SUITE 140, VANCOUVER, WA 98683
(360) 975-4247
(360) 334-6303
Mailing address
19625 62ND AVE S, SUITE A101, KENT, WA 98032-1103
(253) 852-5612
(253) 852-0427
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1109680001
KENT OFFICE
WA
Enumeration date
09/03/2015
Last updated
07/17/2024
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