Healthcare Provider Details

I. General information

NPI: 1063008027
Provider Name (Legal Business Name): ALFALFA FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2020
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25889 ALFALFA MARKET RD
BEND OR
97701-9330
US

IV. Provider business mailing address

25889 ALFALFA MARKET RD
BEND OR
97701-9330
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-2333
  • Fax:
Mailing address:
  • Phone: 541-382-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: CHAD LAVALLEE
Title or Position: FIRE CHIEF
Credential:
Phone: 503-910-6129