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General NPI Number Information
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NPI Number | 1922215714
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Entity Type | Organization
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Legal Business Name | MEDLAW CONFIDENTIAL PLLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 824 GRANT ST SUITE 5
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-2477
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Country | US
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Telephone | 360-385-0812
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1922
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-0064
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Country | US
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Telephone | 360-385-0812
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Fax |
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Authorized Official
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Title or Position | MANAGER, CHIEF PARAMEDIC
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Name | GREG WALSH
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Credential | CRITICAL CARE PM
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Telephone | 360-385-0812
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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 | 16X05
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License Number State | WA
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