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Organization

CITY OF CLE ELUM AMBULANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVE ALLENBAUGH (CHIEF)
(509) 674-2262
Entity
Organization

Contact information

Practice address
301 N PENNSYLVANIA AVE, CLE ELUM, WA 98922-1159
(509) 674-2262
Mailing address
119 W 1ST ST, CLE ELUM, WA 98922-1105
(509) 674-2262

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
19M01
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00053969
RAILROAD MEDICARE
WA
01
0171103
WASHINGTON L&I
WA
05
9054479
WA
Enumeration date
09/28/2006
Last updated
08/22/2020
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