Provider Demographics
NPI:1275049959
Name:WAMSLEY, GENE GORDON (RRT)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:GORDON
Last Name:WAMSLEY
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18017 36TH AVE E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98446-1314
Mailing Address - Country:US
Mailing Address - Phone:760-686-7297
Mailing Address - Fax:
Practice Address - Street 1:18017 36TH AVE E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446-1314
Practice Address - Country:US
Practice Address - Phone:760-686-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60531497227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60531497OtherSTATE OF WASHINGTON RESPIRATORY CARE BOARD