Provider Demographics
NPI:1659811339
Name:OPPEN, BRIAN (EMT-B)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:OPPEN
Suffix:
Gender:M
Credentials:EMT-B
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 1044
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922
Mailing Address - Country:US
Mailing Address - Phone:206-306-4085
Mailing Address - Fax:
Practice Address - Street 1:1001 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-1381
Practice Address - Country:US
Practice Address - Phone:206-306-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAE3253906146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic