1588960561 NPI number — WEST THURSTON REGIONAL FIRE PROTECTION SERVICE AUTHORITY

Table of content: (NPI 1588960561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588960561 NPI number — WEST THURSTON REGIONAL FIRE PROTECTION SERVICE AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST THURSTON REGIONAL FIRE PROTECTION SERVICE AUTHORITY
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:
WEST THURSTON REGIONAL FIRE AUTHORITY
Provider Other Organization Name Type Code:
3
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:
1588960561
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2023
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:
10828 LITTLEROCK RD SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLYMPIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98512-8525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-352-1614
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
ROB
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
360-352-1614

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  34D01 , 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: 615917100 . This is a "OWCP-FECA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0276670 . 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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