OrganizationActive
Pacific Footwear Company, Inc.
NPI 1104148741 · Customized Equipment (DME) · Peoria, AZ
Pacific Footwear Company, Inc. is a Customized Equipment (DME) organization in Peoria, AZ (NPI 1104148741).
Provider details
- NPI number
- 1104148741
- Entity type
- Organization
- Primary specialty
- Customized Equipment (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Kevin Clarke, President(503) 524-9656
Specialties & taxonomies
Suppliers
- Prosthetic/Orthotic Supplier335E00000X
Suppliers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13660 N 94th Dr
Suite F-2
Peoria, AZ 85381-4836
Phone: (623) 302-9396
Fax: (623) 302-9397
Street-level locationGet directions
Mailing address
10240 Sw Nimbus Ave
Portland, OR 97223-4358
Other names (DBA / former)
- Doing business as
- Priority Footwear & Pedorthic Services
Registry dates
- Enumerated
- 2010-02-24
- Last updated
- 2025-04-22
- Certified
- 2025-04-22
Frequently asked questions
- What is Pacific Footwear Company, Inc.'s NPI number?
- Pacific Footwear Company, Inc.'s National Provider Identifier (NPI) is 1104148741, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pacific Footwear Company, Inc.?
- Pacific Footwear Company, Inc. is classified in the NPPES registry as Customized Equipment (DME) (Suppliers).
- Where is Pacific Footwear Company, Inc. located?
- Pacific Footwear Company, Inc.'s practice location on file with NPPES is 13660 N 94th Dr, Peoria, AZ 85381-4836.
- What is Pacific Footwear Company, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Pacific Footwear Company, Inc. is (623) 302-9396.
- Who is the authorized official for Pacific Footwear Company, Inc.?
- The authorized official listed on Pacific Footwear Company, Inc.'s NPPES record is Kevin Clarke, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pacific Footwear Company, Inc.'s NPI active?
- Yes — Pacific Footwear Company, Inc.'s NPI (1104148741) is active in the NPPES registry as of the last update on 2025-04-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.