Provider Demographics
NPI:1659514859
Name:MARITIME EXPEDITIONARY SECURITY SQUADRON NINE
Entity Type:Organization
Organization Name:MARITIME EXPEDITIONARY SECURITY SQUADRON NINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HM
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:DELA CRUZ
Authorized Official - Last Name:CALAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-304-4790
Mailing Address - Street 1:2000 W MARINE VIEW DR BLDG 2134
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98207-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 W MARINE VIEW DR BLDG 2134
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98207-0001
Practice Address - Country:US
Practice Address - Phone:425-304-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865X1600XHospitalsMilitary HospitalMilitary General Acute Care Hospital. Operational (Transportable)