MEDICARE: ISLAND COUNTY FPD 1

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	15D01	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590161373	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	321034001	OTHER	WA	GROUP HEALTH
3	105039	OTHER	WA	DEPT OF LABOR & INDUSTRIE
4	8922406	OTHER	WA	VICTIMS OF CRIME
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0105039	OTHER	WA	L&I AND CRIME VICTIMS
7	ST2402	OTHER	WA	REGENCE

General Provider Information

NPI Number	:	1861416471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLAND COUNTY FPD 1

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	:	811 N SUNRISE BLVD
Second Line	:
City	:	CAMANO ISLAND
State	:	WA
Zip	:	98282-8778
Country	:	US
Telephone Number	:	360-387-1512
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MICHAEL GANZ
Credential	:
Telephone Number	:	360-387-1512

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/15/2012

Similar Medicare Providers

1831185347 — DR. MARK A REED MD
Practice Location Address:

963 SE CAMANO DR
CAMANO ISLAND, WA
98282-8489

Practice Phone: 206-419-7297
Practice Fax:

1851378582 — MRS. KAREN L LAMPE RPH
Practice Location Address:

943 CAMBELL DR
CAMANO ISLAND, WA
98282-7378

Practice Phone: 360-618-0233
Practice Fax:

1760443444 — DR. TRACI LEE DRAKE PHD
Practice Location Address:

869 N SUNRISE BLVD
CAMANO ISLAND, WA
98282-5532

Practice Phone: 253-279-5121
Practice Fax:

1770546798 — DR. RANDALL A THOMPSON DDS
Practice Location Address:

810 REKDAL RD
CAMANO ISLAND, WA
98282-8852

Practice Phone: 360-629-4097
Practice Fax: 360-629-3906

1598799645 — DR. BRUCE CHESSEN PH.D.
Practice Location Address:

3355 SHORELINE DR
CAMANO ISLAND, WA
98282-8223

Practice Phone: 406-248-1126
Practice Fax: 406-245-0948

1356456305 — BLOOMS CAMANO PHARMACY
Practice Location Address:

370 NE CAMANO DR , STE 6
CAMANO ISLAND, WA
98282-7279

Practice Phone: 360-387-5757
Practice Fax: 360-387-3901

Directions to “ISLAND COUNTY FPD 1 ” Practice Location

Language	Start Address	Practice Location

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