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General NPI Number Information
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NPI Number | 1033101191
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Entity Type | Organization
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Legal Business Name | CITY OF MONTESANO
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 04/28/2010
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Provider Practice Location Address
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Address Line | 310 E PIONEER AVE
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City | MONTESANO
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State | WA
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Zip | 98563-4602
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Country | US
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Telephone | 360-249-4851
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Fax | 360-249-4971
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Provider Business Mailing Address
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Address Line | 112 N MAIN ST
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City | MONTESANO
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State | WA
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Zip | 98563-3707
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Country | US
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Telephone | 360-249-4851
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Fax | 360-249-4971
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Authorized Official
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Title or Position | DEPUTY CLERK
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Name | MS. DEBBIE WISDOM
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Credential |
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Telephone | 360-249-4851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 14M06
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License Number State | WA
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