MEDICARE: SNOHOMISH COUNTY FIRE PROT DIST 5

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	31D05	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0232414	OTHER	WA	L&I-CRIME VICTIMS

General Provider Information

NPI Number	:	1346339959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNOHOMISH COUNTY FIRE PROT DIST 5

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	:	32905 CASCADE VIEW DR
Second Line	:
City	:	SULTAN
State	:	WA
Zip	:	98294-8000
Country	:	US
Telephone Number	:	360-793-1179
Fax Number	:	360-799-0563

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	SETH JOHNSON
Credential	:
Telephone Number	:	360-793-1179

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	03/05/2024

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