Provider Demographics
NPI:1083760219
Name:LEWIS COUNTY FIRE DISTRICT NO 10
Entity Type:Organization
Organization Name:LEWIS COUNTY FIRE DISTRICT NO 10
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT SECRETARY
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-494-4123
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:PACKWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98361-0270
Mailing Address - Country:US
Mailing Address - Phone:360-494-4123
Mailing Address - Fax:
Practice Address - Street 1:12953 US HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:PACKWOOD
Practice Address - State:WA
Practice Address - Zip Code:98361-0270
Practice Address - Country:US
Practice Address - Phone:360-494-4123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA21D103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0091002OtherL&I/CRIME VICTIMS
WA590006459OtherRAILROAD MEDICARE
WA9010182Medicaid
WA590006459OtherRAILROAD MEDICARE