NPI 1043833619

Tim Shride

Practitioner Prosthetist Sacramento, CA

Practice location

Address: 3800 Watt Ave STE 151, Sacramento, CA 95821-2688
Phone: (916) 482-1535
Mailing address: 10717 126th Pl NE, Kirkland, WA 98033-4756

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1043833619
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 May 2020
Record last updated: 18 May 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.