Healthcare Provider Details

I. General information

NPI: 1285339614
Provider Name (Legal Business Name): VERNONIA RURAL FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BRIDGE ST E
VERNONIA OR
97064-1406
US

IV. Provider business mailing address

555 BRIDGE ST E
VERNONIA OR
97064-1406
US

V. Phone/Fax

Practice location:
  • Phone: 509-429-8252
  • Fax: 503-429-2900
Mailing address:
  • Phone: 509-429-8252
  • Fax: 503-429-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT DAVIS
Title or Position: CHIEF
Credential:
Phone: 503-686-3117