Healthcare Provider Details

I. General information

NPI: 1750509923
Provider Name (Legal Business Name): STEVENS COUNTY SHERIFF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S OAK ST 108
COLVILLE WA
99114-2862
US

IV. Provider business mailing address

215 S OAK ST 108
COLVILLE WA
99114-2862
US

V. Phone/Fax

Practice location:
  • Phone: 509-684-5296
  • Fax:
Mailing address:
  • Phone: 509-684-5296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. NANCY KRAJCIK
Title or Position: SECRETARY
Credential:
Phone: 509-684-5296