MEDICARE: ISLAND EMERGENCY CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	17X22	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	51934	OTHER	WA	LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1013903558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLAND EMERGENCY CARE INC.

Provider Business Mailing Address
First Line	:	PO BOX 204
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-0204
Country	:	US
Telephone Number	:	206-463-9671
Fax Number	:	206-463-6671

Provider Business Practice Location Address
First Line	:	12412 SW COVE RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-3704
Country	:	US
Telephone Number	:	206-463-9671
Fax Number	:	206-463-6671

Authorized Official
Title or Position	:	PRESIDENCE
Name	:	MS. JOLENE M. LAMB
Credential	:
Telephone Number	:	206-463-9671

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	08/22/2020

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Directions to “ISLAND EMERGENCY CARE INC. ” Practice Location

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