MEDICARE: KING COUNTY FIRE PROTECTION DISTRICT 43

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	17D43	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00342999	OTHER	WA	RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0204864	OTHER	WA	L&I AND CRIME VICTIMS
3	615358300	OTHER	WA	OWCP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8561MA	OTHER	WA	REGENCE

General Provider Information

NPI Number	:	1023080777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING COUNTY FIRE PROTECTION DISTRICT 43

Provider Business Mailing Address
First Line	:	PO BOX 3510
Second Line	:
City	:	SILVERDALE
State	:	WA
Zip	:	98383-3510
Country	:	US
Telephone Number	:	360-394-7030
Fax Number	:	360-394-7097

Provider Business Practice Location Address
First Line	:	23775 SE 264TH ST
Second Line	:
City	:	MAPLE VALLEY
State	:	WA
Zip	:	98038-5843
Country	:	US
Telephone Number	:	425-432-0200
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	BRAD DOERFLINGER
Credential	:
Telephone Number	:	425-432-0200

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	10/30/2012

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Directions to “KING COUNTY FIRE PROTECTION DISTRICT 43 ” Practice Location

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