Provider Demographics
NPI:1558660118
Name:DRUGE, DAN S (MA, PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:DAN
Middle Name:S
Last Name:DRUGE
Suffix:
Gender:M
Credentials:MA, PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0410
Mailing Address - Country:US
Mailing Address - Phone:360-645-2233
Mailing Address - Fax:360-645-2972
Practice Address - Street 1:250 FORT STREET
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:360-645-2972
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAES01169030146L00000X
WAHC 00156710374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No374700000XNursing Service Related ProvidersTechnician