Provider Demographics
NPI:1205922242
Name:NORDSTROM INC & SUBSIDIARIES
Entity type:Organization
Organization Name:NORDSTROM INC & SUBSIDIARIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROSTHESIS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRESHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-454-4060
Mailing Address - Street 1:1617 6TH AVE
Mailing Address - Street 2:ATTN; PROSTHESIS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1707
Mailing Address - Country:US
Mailing Address - Phone:206-454-4060
Mailing Address - Fax:
Practice Address - Street 1:3111 PGA BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2801
Practice Address - Country:US
Practice Address - Phone:561-340-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0435530112Medicare NSC