Town of Eatonville

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

27MO5 Issued in WA

Legal business name

TOWN OF EATONVILLE

Practice address

201 Center Street W
Eatonville, WA 98328

Phone

(360) 832-6931

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Sheila Dudley

Title

Assistant Chief

Phone

(360) 832-6931

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eatonville Fire Department Other name

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1457483679",
    "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": "201 CENTER STREET W",
            "city": "EATONVILLE",
            "state": "WA",
            "postal_code": "98328",
            "telephone_number": "360-832-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF EATONVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "ASSISTANT CHIEF",
        "authorized_official_telephone_number": "360-832-6931"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "27MO5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0191504",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9045899",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eatonville Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• South Pierce Fire and Rescue District No 17
• Jacki L Strader, LMP
• Penny Leah Tanner, PHD, ARNP, PMHNP-BC
• Melissa Dawn Taylor
• Dawn Tippett
• Jennifer Marie Travis, RNFA
• Theresa Ann Tucker
• Laurita Valdez
• Pamela Kay Vogt, C.O.T.A./L
• Jennifer A. Weinmann, LMFT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.