Timothy Bruhn, EMT

Individual provider Active NPI Home Health Agency · Anderson Island, WA

NPI 1619799962 · NPPES record last updated Oct 28, 2024

Key facts

NPI
1619799962
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
Practice address
12207 Lake Josephine Blvd
Anderson Island, WA 98303-8709
Phone
(360) 348-3732
NPI assigned
Oct 28, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
5526-6562-7034WAMDBasic Emergency Medical Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 5526-6562-7034 WA
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

12207 Lake Josephine Blvd
Anderson Island, WA 98303-8709

Mailing address

9521 124TH Ave
Anderson Island, WA 98303-9713
Phone (360) 348-3732

Other providers in Anderson Island, WA

All providers in Anderson Island, WA · Home Health Agency in Washington

Sources for this page

Verify at the official NPI Registry.