Carmen Sundin

Individual provider Active NPI Basic Emergency Medical Technician · Vader, WA

NPI 1720448574 · NPPES record last updated Mar 7, 2016

Key facts

NPI
1720448574
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
AMBV.ES.60271398 (WA)
Practice address
801 B Street
Vader, WA 98593-0194
Phone
(360) 295-0906
Fax
(360) 295-0907
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AMBV.ES.60271398WAMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Fire District No 5 Current Accepting new patients
Cowlitz County-Lewis County Fire District 20 Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X AMBV.ES.60271398 WA Yes

Addresses

Primary practice location

801 B Street
Vader, WA 98593-0194

Mailing address

PO Box 194
Vader, WA 98593-0194
Phone (360) 295-0906

Other providers in Vader, WA

All providers in Vader, WA · Basic Emergency Medical Technician in Washington

Sources for this page

Verify at the official NPI Registry.