PHOENIX RISING HORN (NPI# 1952859381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952859381 |
| Entity Type | Individual |
| Full Name | PHOENIX RISING HORN |
| Credential | EMT PARAMEDIC |
| Practice Address |
Madigan Army Medical Center 9040 Jackson Ave Attn: Mchj-clq-c Tacoma WA 98431-1100 |
| Mailing Address |
Madigan Army Medical Center, 9040 Jackson Ave. Attn: Mchj-clq-c Tacoma WA 98431-1100 |
| Practice Telephone | 2539681100 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146L00000X | Emergency Medical Technician, Paramedic | 146L00000X | WA | Emergency Medical Service Providers |
| Street Address |
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740254 | Dennis Huang | Podiatrist | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2005-06-16 |
| 1891395851 | Juliana Dumayas | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0002 | 2020-10-29 |
| 1922658491 | Fatima Hossay Safi | Social Worker | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-09-17 |
| 1134778095 | Vinzuella Boddie | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-09-04 |
| 1588219059 | Susan Marie Lopez | Dietitian, Registered | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-08-01 |
| 1174177109 | Bradley Scott Miller | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2019-07-29 |
| 1437703568 | Alex Alberto Hernandez Vargas | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-07-26 |
| 1427619733 | Dana Michelle Sanchez-terry | Nurse Practitioner | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431 | 2019-06-26 |
| 1255998076 | Scott Michael Brown | Military Health Care Provider | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-5650 | 2019-05-28 |
| 1861059081 | Nathaniel Alan Castonguay | Licensed Practical Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2019-05-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 146L00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Paramedic |
| An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487145868 | Shayne Leon Sparrow | Emergency Medical Technician, Paramedic | 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-0001 | 2018-05-22 |
| 1366973653 | Amanda Jardin Mihail | Emergency Medical Technician, Paramedic | 9040 Jackson Ave, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-27 |
| 1063878304 | James Anthony Mcmanamon | Emergency Medical Technician, Paramedic | 9040 Reid Street, Attn: Mchj-clq-c Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2015-12-31 |
| 1215307145 | Derron Lamarr Mccoy | Emergency Medical Technician, Paramedic | 9040 Reid Street, Attn: Mchj-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2015-10-05 |
| 1114397965 | Kaleb Joseph Twilligear | Emergency Medical Technician, Paramedic | 9040 Reid Street, Attn: Mchj-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2015-10-05 |
| 1356733661 | Erick Thronson | Emergency Medical Technician, Paramedic | Madigan Army Medical Ctr, Dept of Emergency Medicine, Tacoma, WA 98431-0001 | 2015-02-23 |
| 1992145569 | Kenneth Allen Downs | Emergency Medical Technician, Paramedic | 9600 Veterans Dr, Tacoma, WA 98493-0001 | 2013-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185163 | Eric Koreis | Emergency Medical Technician, Paramedic | 740 Commerce Ave, Longview, WA 98632-2416 | 2020-02-10 |
| 1639645997 | Emily Elisabeth Armstrong | Emergency Medical Technician, Paramedic | 3370 Evergreen Ave, Jblm, WA 98433 | 2018-10-15 |
| 1184164493 | John Jackson | Emergency Medical Technician, Paramedic | 137 S Newport Ave, Newport, WA 99156-1942 | 2017-03-06 |
| 1457807174 | Nathan Ziegman | Emergency Medical Technician, Paramedic | 4259 23rd Avenue West, Seattle, WA 98199 | 2016-09-01 |
| 1730534629 | Chance Shaffner | Emergency Medical Technician, Paramedic | 1117 14th St, Anacortes, WA 98221-2127 | 2016-04-27 |
| 1083084743 | Marcos Collazo | Emergency Medical Technician, Paramedic | 4259 23rd Ave W Ste 200, Seattle, WA 98199-1534 | 2015-10-06 |
| 1972994135 | Eric Perkins | Emergency Medical Technician, Paramedic | 14971 Deception Rd, Anacortes, WA 98221-8229 | 2015-02-10 |
| 1720484231 | Christopher John Washburn | Emergency Medical Technician, Paramedic | 6386 Chico Way Nw, Bremerton, WA 98312-1154 | 2014-11-10 |
| 1699187740 | Patrick Moe | Emergency Medical Technician, Paramedic | 5648 E Hillcrest Dr, Port Orchard, WA 98366-8120 | 2014-05-23 |
| 1194985499 | Lisa Hall | Emergency Medical Technician, Paramedic | 1505 Kal-ook-wah Drive, Taholah, WA 98587 | 2008-06-11 |
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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.