Healthcare Provider Details

I. General information

NPI: 1689858722
Provider Name (Legal Business Name): CLALLAM COUNTY FIRE DISTRICT 5
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 EAGLE CREST WAY
CLALLAM BAY WA
98326
US

IV. Provider business mailing address

PO BOX 3510
SILVERDALE WA
98383-3510
US

V. Phone/Fax

Practice location:
  • Phone: 360-963-2371
  • Fax:
Mailing address:
  • Phone: 360-394-7030
  • Fax: 360-394-7097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number05D05
License Number StateWA

VIII. Authorized Official

Name: JAY D MATSEN
Title or Position: EMS BILLING SUPERVISOR
Credential:
Phone: 253-313-3591