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General NPI Number Information
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NPI Number | 1720004112
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Entity Type | Organization
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Legal Business Name | CITY OF WALLA WALLA
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 170 N WILBUR AVE
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City | WALLA WALLA
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State | WA
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Zip | 99362-2548
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Country | US
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Telephone | 509-529-4083
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Fax | 509-529-0694
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Provider Business Mailing Address
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Address Line | 170 N WILBUR AVE
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City | WALLA WALLA
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State | WA
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Zip | 99362-2548
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Country | US
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Telephone | 509-529-4083
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Fax | 509-529-0694
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Authorized Official
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Title or Position | DEPUTY CHIEF OF EMS
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Name | MR. FRED HECTOR
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Credential |
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Telephone | 509-524-4630
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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 | 36M04
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License Number State | WA
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