WILDERNESS SHORES SUPPLIES, LLC
NPI 1144545054
Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition in Maple Valley, WA

Q: What is Wilderness Shores Supplies, LLC's NPI number?

The NPI number for Wilderness Shores Supplies, LLC is 1144545054. It was assigned to this organization in the NPPES registry on April 2, 2010.

Q: What is Wilderness Shores Supplies, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Parenteral & Enteral Nutrition, with taxonomy code 332BP3500X.

Active since April 02, 2010

25614 LAKE WILDERNESS LN SE, MAPLE VALLEY, WA 98038(206) 931-5284(425) 413-5116 Get Directions Write a Review

NPPES record last updated: April 2, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Wilderness Shores Supplies, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILDERNESS SHORES SUPPLIES, LLC (NPI 1144545054) is a healthcare organization registered as a parenteral & enteral nutrition in Maple Valley, Washington and active in the NPI registry since April 2010. The organization lists Shirley Ann Mcmonagle, Owner, as its authorized official.

NPPES Registry Identity

NPI1144545054

Entity TypeOrganization

Primary Taxonomy332BP3500X

Legal Business NameWILDERNESS SHORES SUPPLIES, LLC

Location Address25614 LAKE WILDERNESS LN SEMaple Valley, WA 98038-6019

Mailing Address25614 Lake Wilderness Ln SeMaple Valley, WA 98038-6019 · (206) 931-5284 · Fax (425) 413-5116

Phone(206) 931-5284

Fax(425) 413-5116

Organization SubpartNo

Authorized OfficialShirley Ann McmonagleOwner · (206) 931-5284

Enumeration DateApril 2, 2010

✔ NPI 1144545054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDurable Medical Equipment & Medical Supplies · Parenteral & Enteral NutritionSuppliers

Taxonomy Code332BP3500X

Also ListedDurable Medical Equipment & Medical Supplies · Oxygen Equipment & SuppliesTaxonomy 332BX2000X

25614 LAKE WILDERNESS LN SE, Maple Valley, WA 98038

Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILDERNESS SHORES NURSING, LLC

Home Health

25614 LAKE WILDERNESS LN SE
MAPLE VALLEY, WA 98038

King County (206) 931-5284

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wilderness Shores Supplies, LLC's NPI number?

The NPI number for Wilderness Shores Supplies, LLC is 1144545054. It was assigned to this organization in the NPPES registry on April 2, 2010.

Where is Wilderness Shores Supplies, LLC located?

Wilderness Shores Supplies, LLC is located at 25614 Lake Wilderness Ln SE, Maple Valley, WA 98038. The listed phone number is (206) 931-5284.

What is Wilderness Shores Supplies, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Parenteral & Enteral Nutrition, with taxonomy code 332BP3500X.

When was this NPI record last updated?

The NPPES record for Wilderness Shores Supplies, LLC was last updated on April 2, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.