PACIFIC FOOTWEAR COMPANY, INC. – NPI #1831353200
Durable Medical Equipment & Medical Supplies

PACIFIC FOOTWEAR COMPANY, INC. is a DME supplier located in SEATTLE, WA. NPPES has assigned the NPI number 1831353200 to PACIFIC FOOTWEAR COMPANY, INC. on July 15, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 332BC3200X from the Health Care Provider Taxonomy code set, which is classified as Durable Medical Equipment & Medical Supplies, specializing in Customized Equipment

The NPI profile was last updated on Apr 22, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PACIFIC FOOTWEAR COMPANY, INC. below.

NPI Profile for
PACIFIC FOOTWEAR COMPANY, INC.

NPI Number
1831353200
Enumeration Date

(about 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PACIFIC FOOTWEAR COMPANY, INC.
Primary location
2150 N 107TH ST
SUITE 204
SEATTLE, WA 98133-1305
Phone: (206) 957-7772 Fax: (206) 957-6021
Mailing address
10240 SW NIMBUS AVE
SUITE L1
PORTLAND, OR 97223-4358
Phone: (503) 524-9656 Fax: (503) 524-8397
Organization Subpart
No
Authorized Official
KEVIN CLARKE
PRESIDENT
Phone: (206) 957-7772
Updated
Certification Date
Apr 22, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PACIFIC FOOTWEAR COMPANY, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidWA9054784
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.