1346339959 NPI number — SNOHOMISH COUNTY FIRE PROT DIST 5

Table of content: (NPI 1346339959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346339959 NPI number — SNOHOMISH COUNTY FIRE PROT DIST 5

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SNOHOMISH COUNTY FIRE PROT DIST 5
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346339959
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32905 CASCADE VIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SULTAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98294-8000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-793-1179
Provider Business Practice Location Address Fax Number:
360-799-0563
Provider Enumeration Date:
10/12/2006

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  31D05 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1043825 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0232414 . This is a "L&I-CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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