Healthcare Provider Details

I. General information

NPI: 1245231760
Provider Name (Legal Business Name): SISTERS RURAL FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S ELM ST
SISTERS OR
97759
US

IV. Provider business mailing address

PO BOX 3510
SILVERDALE WA
98383-3510
US

V. Phone/Fax

Practice location:
  • Phone: 541-549-0771
  • Fax: 541-549-1343
Mailing address:
  • Phone: 360-394-7020
  • Fax: 360-394-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number090305
License Number StateOR

VIII. Authorized Official

Name: MR. ROGER T JOHNSON
Title or Position: FIRE CHIEF
Credential:
Phone: 541-549-0771