Provider Demographics
NPI:1336114172
Name:COLUMBIA RIVER FIRE & RESCUE
Entity Type:Organization
Organization Name:COLUMBIA RIVER FIRE & RESCUE
Other - Org Name:ST HELENS RURAL FIRE DISTRICT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FIRE CHIEF COLUMBIA RIVER FIRE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:MUNSON
Authorized Official - Last Name:TAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-397-2900
Mailing Address - Street 1:270 COLUMBIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ST HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-2022
Mailing Address - Country:US
Mailing Address - Phone:503-397-2990
Mailing Address - Fax:503-397-3198
Practice Address - Street 1:105 SOUTH 12TH STREET
Practice Address - Street 2:
Practice Address - City:ST HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-2022
Practice Address - Country:US
Practice Address - Phone:503-397-2990
Practice Address - Fax:503-397-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0506063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9020207OtherDEPT OF SOCIAL AND HEALTH
WA0061356OtherDEPT OF LABOR BLACK LUNG
OR222661Medicaid
OR222661Medicaid
W20198Medicare UPIN
ORR0000RGBKHMedicare ID - Type Unspecified