Provider Demographics
NPI:1518284694
Name:LEWIS COUNTY FIRE DISTRICT NO 9
Entity Type:Organization
Organization Name:LEWIS COUNTY FIRE DISTRICT NO 9
Other - Org Name:MINERAL FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-269-1977
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:360-394-7030
Mailing Address - Fax:360-394-7097
Practice Address - Street 1:104 FRONT STREET W
Practice Address - Street 2:
Practice Address - City:MINERAL
Practice Address - State:WA
Practice Address - Zip Code:98355
Practice Address - Country:US
Practice Address - Phone:360-492-5942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA21D093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0263332OtherL&I AND CRIME VICTIMS
WA2006848Medicaid
WA2006848Medicaid