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General NPI Number Information
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NPI Number | 1255403051
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Entity Type | Organization
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Legal Business Name | TONASKET EMERGENCY MEDICAL SERVICES
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 18 EAST FOURTH STREET
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City | TONASKET
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State | WA
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Zip | 98855
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Country | US
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Telephone | 509-560-0080
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Fax | 877-398-3107
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Provider Business Mailing Address
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Address Line | PO BOX 2029
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City | GIG HARBOR
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State | WA
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Zip | 98335
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Country | US
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Telephone | 509-560-0080
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Fax | 877-398-3107
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Authorized Official
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Title or Position | MSO
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Name | MICHAEL S GREENE
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Credential |
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Telephone | 509-560-0080
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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 | 24X09
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 22X01
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License Number State | WA
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