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General NPI Number Information
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NPI Number | 1518933886
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Entity Type | Organization
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Legal Business Name | PIERCE COUNTY FIRE PROT DIST #17
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 302 MCNAUGHT ST S
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City | ROY
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State | WA
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Zip | 98580
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Country | US
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Telephone | 253-843-2425
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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 | 360-613-1627
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Fax | 360-698-4968
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Authorized Official
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Title or Position | ASSISTANT FIRE CHIEF
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Name | SAM YOUNT
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Credential |
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Telephone | 253-377-1963
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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 | 27D17
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License Number State | WA
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