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General NPI Number Information
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NPI Number | 1104862184
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Entity Type | Organization
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Legal Business Name | CLALLAM COUNTY FIRE PROT DIST 4
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 51250 HIGHWAY 112
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City | PORT ANGELES
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State | WA
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Zip | 98363-8766
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Country | US
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Telephone | 360-928-3132
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3510
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City | SILVERDALE
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State | WA
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Zip | 98383-3510
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Country | US
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Telephone | 360-394-7020
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Fax | 360-394-7099
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | GREGORY THOMAS WATERS
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Credential |
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Telephone | 360-928-3132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 05D04
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License Number State | WA
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