Organization
RED MOUNTAIN FIELD CASE MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN M. TABER RN, CCM (PRESIDENT/RN CERTIFIED CASE MANAGER)
(509) 851-8707
Entity
Organization
Contact information
Practice address
51621 DEMOSS RD, BENTON CITY, WA 99320
(509) 851-8707
(509) 588-3532
Mailing address
51621 DEMOSS RD, BENTON CITY, WA 99320
(509) 851-8707
(509) 588-3532
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
00090060
WA
171M00000X
Case Manager/Care Coordinator
RN00110622
WA
251B00000X
Case Management Agency
Primary
00090060
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0263853
DEPT OF LABOR INDUSTRIES
WA
Enumeration date
12/02/2010
Last updated
12/02/2010
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