NPI 1033101191

City of Montesano

Organisation Land Ambulance Montesano, WA

Practice location

Address: 310 E Pioneer Ave, Montesano, WA 98563-4602
Phone: (360) 249-4851
Fax: (360) 249-4971
Mailing address: 112 N Main St, Montesano, WA 98563-3707

Authorised official

Name: Debbie Wisdom
Title: Deputy Clerk
Phone: (360) 249-4851

Registered specialties

Land Ambulance Primary

Transportation Services Taxonomy 3416L0300X Licence 14M06 (WA)

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Registry record

NPI: 1033101191
Entity type: Organization
NPI issued: 16 Aug 2005
Record last updated: 28 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.