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General NPI Number Information
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NPI Number | 1366873044
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Entity Type | Organization
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Legal Business Name | KLICKITAT COUNTY EMERGENCY MEDICAL SERVICES NO 1
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 310 S ROOSEVELT AVE
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City | GOLDENDALE
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State | WA
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Zip | 98620-9201
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Country | US
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Telephone | 509-773-4022
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Fax | 509-773-1941
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Provider Business Mailing Address
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Address Line | PO BOX 455
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City | DALLESPORT
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State | WA
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Zip | 98617-0455
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Country | US
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Telephone | 509-773-4022
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Fax | 509-773-1941
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Authorized Official
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Title or Position | CHIEF OF EMS OPERATIONS
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Name | WILLIAM EARL HARRYMAN
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Credential |
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Telephone | 509-767-7054
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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 |
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License Number State |
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