Healthcare Provider Details

I. General information

NPI: 1851218325
Provider Name (Legal Business Name): JOSEPH KOSLOSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 MAIN ST E
BONNEY LAKE WA
98391-9237
US

IV. Provider business mailing address

13218 96TH AVE NW
GIG HARBOR WA
98329-8659
US

V. Phone/Fax

Practice location:
  • Phone: 253-592-7309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberEMT.ES.61314634
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: