Healthcare Provider Details

I. General information

NPI: 1679230585
Provider Name (Legal Business Name): ANTHONY COSME EMT, MAP, NAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13020 MERIDIAN AVE S
EVERETT WA
98208-6468
US

IV. Provider business mailing address

13105 21ST DR SE APT C102
EVERETT WA
98208-7158
US

V. Phone/Fax

Practice location:
  • Phone: 425-357-3900
  • Fax:
Mailing address:
  • Phone: 425-287-9056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: