King Co Fire Dist No 10

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

17D10 Issued in WA

Legal business name

KING CO FIRE DIST NO 10

Practice address

175 Newport Way NW
Issaquah, WA 98027-3104

Phone

(425) 392-3433

Fax

(425) 391-8764

NPI assigned

Nov 19, 2010

Organization subpart

No

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

Authorized official

Name

Lee Soptich

Title

Fire Chief

Phone

(425) 313-3201

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Eastside Fire & Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1255633475",
    "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": "360-394-7030",
            "fax_number": "360-394-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 NEWPORT WAY NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273104",
            "telephone_number": "425-392-3433",
            "fax_number": "425-391-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING CO FIRE DIST NO 10",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "SOPTICH",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "425-313-3201"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "17D10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "615685300",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010482",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0272906",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Fire & Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Kim, MD
• Jessica D Kim, MPH, RD, CD
• Joyce Kim, DPT
• Indigo Kimmel, BT
• Travis J. Kinane, DO
• Corie Megan King-Langin, FNP-BC
• Jeremy King, OTR
• Robin Peters King, CRNA
• Jacky Kingsada, NP
• William H Kinnish, MD

• Land Ambulance in Issaquah, WA
• Providers in Issaquah, 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 5, 2011; 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.