Individual
NATHAN SOUTHWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22210 N GLADE RD, MESA, WA 99343-7000
(509) 521-2507
Mailing address
PO BOX 52, MESA, WA 99343-0052
(509) 528-8583
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
7236-9440-4108
WA
Other
Enumeration date
03/29/2025
Last updated
03/29/2025
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