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General NPI Number Information
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NPI Number | 1609747195
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Entity Type | Organization
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Legal Business Name | CLARK-COWLITZ FIRE RESCUE
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 911 N 65TH AVE
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City | RIDGEFIELD
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State | WA
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Zip | 98642-7725
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Country | US
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Telephone | 360-887-4609
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Fax | 360-887-0862
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Provider Business Mailing Address
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Address Line | 911 N 65TH AVE
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City | RIDGEFIELD
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State | WA
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Zip | 98642-7725
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Country | US
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Telephone | 360-887-4609
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Fax | 360-887-0862
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH CRISIS RESPONDER
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Name | STEPHANIE NICOLE ROEST
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Credential |
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Telephone | 360-887-1684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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