Healthcare Provider Details

I. General information

NPI: 1346017944
Provider Name (Legal Business Name): NORTH MASON REGIONAL FIRE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 NE OLD BELFAIR HWY
BELFAIR WA
98528-9637
US

IV. Provider business mailing address

PO BOX 277
BELFAIR WA
98528-0277
US

V. Phone/Fax

Practice location:
  • Phone: 360-275-6711
  • Fax:
Mailing address:
  • Phone: 360-275-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BEAU ALAN BAKKEN
Title or Position: FIRE CHIEF
Credential:
Phone: 360-275-6711