Organization
CRESAP ORTHOTICS & PROSTHETICS, INC.
Active
Organization
CRESAP ORTHOTICS & PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN DOMINIC CRESAP C.P.O. (PRESIDENT)
(509) 663-2490
Entity
Organization
Contact information
Practice address
630 N CHELAN AVE, A-5, WENATCHEE, WA 98801-6622
(509) 663-2490
(509) 663-2147
Mailing address
630 N CHELAN AVE, A-5, WENATCHEE, WA 98801-6622
(509) 663-2490
(509) 663-2147
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
OI00000163
WA
335E00000X
Prosthetic/Orthotic Supplier
Primary
PS00000162
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9048216
—
WA
Enumeration date
01/09/2007
Last updated
08/27/2009
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