City of Montesano

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

14M06 Issued in WA

Legal business name

CITY OF MONTESANO

Practice address

310 E Pioneer Ave
Montesano, WA 98563-4602

Phone

(360) 249-4851

Fax

(360) 249-4971

NPI assigned

Aug 16, 2005

Organization subpart

Yes

Parent organization

CITY OF MONTESANOAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Debbie Wisdom

Title

Deputy Clerk

Phone

(360) 249-4851

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• City of montesano Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Part of

City of Montesano

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1033101191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N MAIN ST",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633707",
            "telephone_number": "360-249-4851",
            "fax_number": "360-249-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E PIONEER AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985634602",
            "telephone_number": "360-249-4851",
            "fax_number": "360-249-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MONTESANO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY OF MONTESANO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DEPUTY CLERK",
        "authorized_official_telephone_number": "360-249-4851",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "14M06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9279803",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of montesano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Capital Medical Center Physicians LLC
• Rowena Maderazo Caratao, M.D.
• Nancy Carolyn Chambers
• Chaplains on the Harbor
• Roberta Cheville, PTA
• Celina Clark, LMT
• Susan Marie Clark, M. ED.
• Brooke Colburn
• Connections, a Center for Healthy Families
• Connections, a Center for Healthy Families

• Land Ambulance in Montesano, WA
• Providers in Montesano, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.