MONTANA WYNN GUBRUD (NPI# 1609404409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609404409 |
| Entity Type | Individual |
| Full Name | MONTANA WYNN GUBRUD |
| Practice Address |
1705 Dock St Unit 334 Tacoma WA 98402-3216 |
| Practice Telephone | 9704014070 |
| Mailing Telephone | 9704014070 |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2020-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | EMT.ES.61027626 | WA | Emergency Medical Service Providers |
| Street Address |
1705 DOCK ST UNIT 334 |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-3216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679183412 | Alexandra Grace Wooten | Emergency Medical Technician, Basic | 5043 N Visscher St, Tacoma, WA 98407-2112 | 2020-08-06 |
| 1306311667 | Michael Dean Torres | Emergency Medical Technician, Basic | Madigan Army Medical Center, 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2018-10-12 |
| 1285125351 | Xinhui Huang | Emergency Medical Technician, Basic | 4815 Wa Tau Ga Ave Ne, Tacoma, WA 98422-1757 | 2018-05-24 |
| 1104344472 | Chalsea Jayne Hicks Nerys | Emergency Medical Technician, Basic | Madigan Army Medical Center Attn: Mchj-clq-c, Tacoma, WA 98431-0001 | 2017-09-06 |
| 1689038705 | William Anthony Bermoy IIi | Emergency Medical Technician, Basic | 9040 Jackson Ave, Attn: Mchj-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1100 | 2016-04-06 |
| 1710344015 | Matthew C Dayoe | Emergency Medical Technician, Basic | 9040 Reid St, Attn: Mchj-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2016-01-19 |
| 1215308804 | Ulysses Mendez | Emergency Medical Technician, Basic | 9040 Reid Street Madigan Army Medical Ctr, Attn: Mchj-clq-c, Tacoma, WA 98431-1000 | 2015-10-08 |
| 1689236507 | Meredith Anna Russell | Emergency Medical Technician, Basic | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-07-01 |
| 1386107456 | Robert De La Pena Jr. | Emergency Medical Technician, Basic | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-04-07 |
| 1366918625 | Rafcel Gabriel Hernandez | Emergency Medical Technician, Basic | Madigan Army Medical Center, 9040 Jackson Ave, Attn: Mchj-clq-c, Tacoma, WA 98433-1100 | 2018-10-15 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.