Healthcare Provider Details

I. General information

NPI: 1457300691
Provider Name (Legal Business Name): WASHINGTON EM-I MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HOSPITAL DR
SEDRO WOOLLEY WA
98284-4327
US

IV. Provider business mailing address

PO BOX 8459
PHILADELPHIA PA
19101-8459
US

V. Phone/Fax

Practice location:
  • Phone: 360-856-7110
  • Fax:
Mailing address:
  • Phone: 805-563-3011
  • Fax: 805-564-5087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGEL L ISCOVICH
Title or Position: PRESIDENT
Credential: MD
Phone: 800-230-5160