Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pacific Footwear Company, Inc

Organization Customized Equipment (DME) · NPI 1104148741

Pacific Footwear Company, Inc is a Customized Equipment (DME) in Peoria, Arizona. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13660 N 94th Dr Ste F-2
Peoria, AZ 85381-4836
Phone: (623) 302-9396
Fax: (623) 302-9397
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Customized Equipment (DME) (primary) Taxonomy 332BC3200X
Prosthetic/Orthotic Supplier Taxonomy 335E00000X

Record details

NPI number1104148741
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Clarke — President · (503) 524-9656
Other names Priority Footwear & Pedorthic Services
NPI enumeratedFebruary 24, 2010
Last updated in NPPESApril 22, 2025
Certification dateApril 22, 2025
Mailing address10240 Sw Nimbus Ave, Suite L1, Portland, OR 97223-4358

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