City of Mountlake Terrace

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

31M10 Issued in WA

Legal business name

CITY OF MOUNTLAKE TERRACE

Practice address

12310 Meridian Ave S
Everett, WA 98208-5764

Phone

(425) 551-1200

NPI assigned

Feb 24, 2006

Organization subpart

No

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

Authorized official

Name

Ed Widdis

Title

Fire Chief

Phone

(425) 551-1200

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mountlake Terrace Fire Department Other name

Locations

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1215903778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-613-1627",
            "fax_number": "360-698-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12310 MERIDIAN AVE S",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085764",
            "telephone_number": "425-551-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MOUNTLAKE TERRACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "WIDDIS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "425-551-1200"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "31M10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9046400",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "126918",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8923187",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "MO3655",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountlake Terrace Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• William Stuart Church, O.D.
• Linda R Ciaramitaro, ARNP
• Cindy Hy OD, Inc.
• Citrine Health
• City of Everett
• Bryce David Civic, DO
• Steve Clancy, PH.D.
• Elisabeth Lorraine Clapper, BA
• Shermoin Rena Clardy, LICSW, SUDPT
• Lynne Marguerite Clark McNamara, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.