Provider Demographics
NPI:1366687717
Name:COUNTY OF BENTON FIRE DISTRICT NO 1
Entity Type:Organization
Organization Name:COUNTY OF BENTON FIRE DISTRICT NO 1
Other - Org Name:BENTON COUNTY FIRE DISTRICT 1
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-737-0911
Mailing Address - Street 1:PO BOX 3510
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-3510
Mailing Address - Country:US
Mailing Address - Phone:360-394-7020
Mailing Address - Fax:360-394-7099
Practice Address - Street 1:7511 W ARROWHEAD AVE
Practice Address - Street 2:SUITE G
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1179
Practice Address - Country:US
Practice Address - Phone:509-737-0911
Practice Address - Fax:509-737-0927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA03D01146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0055135OtherL&I/CRIME VICTIMS
WA55135OtherDEPARTMENT OF LABOR AND INDUSTRIES