OrganizationActive
Wilderness Shores Supplies, LLC
NPI 1144545054 · Parenteral & Enteral Nutrition Supplies (DME) · Maple Valley, WA
Provider details
- NPI number
- 1144545054
- Entity type
- Organization
- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Shirley Mcmonagle, Owner(206) 931-5284
Specialties & taxonomies
Suppliers
- Oxygen Equipment & Supplies (DME)332BX2000X
Suppliers
Practice location
25614 Lake Wilderness Ln Se
Maple Valley, WA 98038-6019
Phone: (206) 931-5284
Fax: (425) 413-5116
Approximate (ZIP-level) locationGet directions
Mailing address
25614 Lake Wilderness Ln Se
Maple Valley, WA 98038-6019
Registry dates
- Enumerated
- 2010-04-02
- Last updated
- 2010-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.