Provider Demographics
NPI:1457328973
Name:PIERCE COUNTY FIRE DISTRICT 14
Entity Type:Organization
Organization Name:PIERCE COUNTY FIRE DISTRICT 14
Other - Org Name:RIVERSIDE FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-922-5644
Mailing Address - Street 1:PO BOX 2029
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-4029
Mailing Address - Country:US
Mailing Address - Phone:253-922-5644
Mailing Address - Fax:253-252-7941
Practice Address - Street 1:4114 56TH AVENUE E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371
Practice Address - Country:US
Practice Address - Phone:253-922-5644
Practice Address - Fax:253-252-7941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA27D143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0172385OtherL&I AND CRIME VICTIMS
WA4389RIOtherREGENCE
WA9054107Medicaid
WA4389RIOtherREGENCE