MEDICARE: CLALLAM COUNTY FIRE PROT DIST 4

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	05D04	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0213981	OTHER	WA	LABOR & INDUSTRIES
2	8942804	OTHER	WA	CRIME VICTIMS
3	4590CL	OTHER	WA	REGENCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104862184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLALLAM COUNTY FIRE PROT DIST 4

Provider Business Mailing Address
First Line	:	PO BOX 3510
Second Line	:
City	:	SILVERDALE
State	:	WA
Zip	:	98383-3510
Country	:	US
Telephone Number	:	360-394-7020
Fax Number	:	360-394-7099

Provider Business Practice Location Address
First Line	:	51250 HIGHWAY 112
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98363-8766
Country	:	US
Telephone Number	:	360-928-3132
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	GREGORY THOMAS WATERS
Credential	:
Telephone Number	:	360-928-3132

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	06/12/2023

Similar Medicare Providers

1649581653 — DR. JOSEPH FLAHERTY CHURCHILL D.D.S.
Practice Location Address:

LOWER ELWHA DENTAL CLINIC , 243511 US 101
PORT ANGELES, WA
98363

Practice Phone: 360-452-6252
Practice Fax: 360-797-1369

1417956061 — TAMARA DZIADEK PT
Practice Location Address:

1106 HAZEL ST
PORT ANGELES, WA
98363-2302

Practice Phone: 360-417-9484
Practice Fax: 360-417-8826

1881694321 — MR. KENNETH EISENBERGER LICSW, DCSW
Practice Location Address:

1303 S O ST
PORT ANGELES, WA
98363-1218

Practice Phone: 360-626-1457
Practice Fax: 360-626-1457

1548253198 — CHARLOTTE L METZLER MD
Practice Location Address:

4407 FAIRMOUNT AVE
PORT ANGELES, WA
98363-9514

Practice Phone: 360-457-0760
Practice Fax: 360-457-0920

1639155906 — MS. MARLINA M BROOKS NURSE
Practice Location Address:

141 E LYRE RIVER RD
PORT ANGELES, WA
98363-8618

Practice Phone: 360-928-3257
Practice Fax:

1538197207 — JOEL FULLER YELLAND MD
Practice Location Address:

243511 WEST HIGHWAY 101 , LOWER ELWHA HEALTH CLINIC
PORT ANGELES, WA
98363-9472

Practice Phone: 360-452-6252
Practice Fax: 360-452-6274

Directions to “CLALLAM COUNTY FIRE PROT DIST 4 ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.