Healthcare Provider Details

I. General information

NPI: 1558660118
Provider Name (Legal Business Name): DAN S DRUGE MA, PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 FORT STREET
NEAH BAY WA
98357
US

IV. Provider business mailing address

PO BOX 410
NEAH BAY WA
98357-0410
US

V. Phone/Fax

Practice location:
  • Phone: 360-645-2233
  • Fax: 360-645-2972
Mailing address:
  • Phone: 360-645-2233
  • Fax: 360-645-2972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberES01169030
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License NumberHC 00156710
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: