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General NPI Number Information
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NPI Number | 1154468627
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Entity Type | Organization
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Legal Business Name | LEWIS COUNTY FPD 4
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 105 THIRD ST.
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City | MORTON
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State | WA
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Zip | 98356
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Country | US
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Telephone | 360-496-5183
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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 | 360-394-7030
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Fax | 360-394-7097
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Authorized Official
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Title or Position | EMS CAPTAIN
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Name | MICHELLE L HARBAUGH
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Credential |
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Telephone | 360-496-1283
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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 | 21D04
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License Number State | WA
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