1871569137 NPI number — EAST PIERCE FIRE & RESCUE

Table of content: (NPI 1871569137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871569137 NPI number — EAST PIERCE FIRE & RESCUE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EAST PIERCE FIRE & RESCUE
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:
PIERCE COUNTY FPD 22
Provider Other Organization Name Type Code:
5
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:
1871569137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2022
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:
18421 VETERANS MEMORIAL DR E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BONNEY LAKE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98391-7109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-863-1800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARKINSON
Authorized Official First Name:
JON
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
253-863-1800

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  27D22 , 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: GA193WA , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0187491 . This is a "L&I AND CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 6193EA . This is a "REGENCE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 608116400 . This is a "FEDERAL OWCP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 807016200 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9055989 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0442068 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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