| Organization Name: | OPTION 1 NORTHWEST ENTERAL LLC |
| NPI Number: | 1043398407 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLEN CHARLESWORTH (CFO) |
| Mailing Address: | 8633 South 212th Street Kent |
| State: | WA US |
| Postal Code: | 98031 |
| Phone Number: | 8888852386 |
| Fax Number: | 8885993448 |
| NPI Enumeration Date: | 11/02/2006 |
| NPI Last Update Date: | 01/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |