Provider Demographics
NPI:1417368333
Name:BRITTAIN, KYLE (EMT-BASIC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:BRITTAIN
Suffix:
Gender:M
Credentials:EMT-BASIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9113 NE 74TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-3756
Mailing Address - Country:US
Mailing Address - Phone:503-729-0535
Mailing Address - Fax:
Practice Address - Street 1:9113 NE 74TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-3756
Practice Address - Country:US
Practice Address - Phone:503-729-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic