Provider Demographics
NPI:1457493447
Name:GRAYS HARBOR COUNTY FIRE PROTECTION DISTRICT #4
Entity Type:Organization
Organization Name:GRAYS HARBOR COUNTY FIRE PROTECTION DISTRICT #4
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-288-2611
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:QUINAULT
Mailing Address - State:WA
Mailing Address - Zip Code:98575-0008
Mailing Address - Country:US
Mailing Address - Phone:360-288-2611
Mailing Address - Fax:
Practice Address - Street 1:6116 US HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:AMANDA PARK
Practice Address - State:WA
Practice Address - Zip Code:98526
Practice Address - Country:US
Practice Address - Phone:360-288-2611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14D043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9160300Medicaid