Organization
PEND OREILLE PARAMEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JACKSON (PRESIDENT)
(509) 671-6699
Entity
Organization
Contact information
Practice address
137 S NEWPORT AVE, NEWPORT, WA 99156-1942
(509) 447-1200
(509) 447-1201
Mailing address
PO BOX 1942, 137 S NEWPORT AVE, NEWPORT, WA 99156-1942
(509) 447-1202
(509) 447-1201
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
604090652
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2089321
—
WA
Enumeration date
04/07/2017
Last updated
02/05/2018
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