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General NPI Number Information
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NPI Number | 1760517981
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Entity Type | Organization
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Legal Business Name | JEFFERSON COUNTY FIRE PROTECTION DISTRICT #4
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 272 SCHOOLHOUSE ROAD
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City | BRINNON
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State | WA
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Zip | 98320
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Country | US
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Telephone | 360-796-4450
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Fax | 360-796-3999
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Provider Business Mailing Address
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Address Line | PO BOX 42
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City | BRINNON
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State | WA
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Zip | 98320-0042
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Country | US
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Telephone | 360-796-4450
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Fax | 360-796-3999
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Authorized Official
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Title or Position | CHAIRMAN BOARD OF FIRE COMMISSIONER
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Name | MR. RONALD D GARRISON
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Credential |
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Telephone | 360-795-4450
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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 | 16D04
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License Number State | WA
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