Healthcare Provider Details

I. General information

NPI: 1366401952
Provider Name (Legal Business Name): DARRINGTON AMBULANCE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 SEEMAN ST
DARRINGTON WA
98241-9102
US

IV. Provider business mailing address

PO BOX 3510
SILVERDALE WA
98383-3510
US

V. Phone/Fax

Practice location:
  • Phone: 360-436-0357
  • Fax:
Mailing address:
  • Phone: 360-394-7030
  • Fax: 360-394-7097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number31X03
License Number StateWA

VIII. Authorized Official

Name: LEILA DEMPSEY
Title or Position: MEDICAL SERVICES OFFICER
Credential:
Phone: 360-436-0357