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General NPI Number Information
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NPI Number | 1194028571
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Entity Type | Organization
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Legal Business Name | SHORELINE FIRE DEPARTMENT
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 17525 AURORA AVE N
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City | SHORELINE
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State | WA
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Zip | 98133-4812
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Country | US
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Telephone | 206-533-6500
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Fax | 206-546-5719
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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 | FIRE CHIEF
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Name | MARK B BUNJE
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Credential |
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Telephone | 206-533-6500
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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 | 17D04
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License Number State | WA
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