Active NPI
Jake Ryan Chastain
- Basic Emergency Medical Technician
- Sedro Woolley, WA
National Provider Identifier
1043753486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- ES. 60623189
- Practice address
- 374 Rainbow Dr
Sedro Woolley, WA 98284-9587 - Phone
- (425) 327-3396
- NPI assigned
- Dec 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | ES. 60623189 | WA | Primary |
Addresses
Primary practice location
374 Rainbow Dr
Sedro Woolley, WA 98284-9587
Mailing address
374 Rainbow Dr
Sedro Woolley, WA 98284-9587
Phone (425) 327-3396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ES. 60623189 | WA | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1043753486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "374 RAINBOW DR",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "982849587",
"telephone_number": "425-327-3396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 RAINBOW DR",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "982849587",
"telephone_number": "425-327-3396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASTAIN",
"first_name": "JAKE",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-01",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "WA",
"license": "ES. 60623189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedro Woolley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.