Provider Demographics
NPI:1679956064
Name:LEWIS COUNTY FIRE PROTECTION DISTRICT NUMBER 15
Entity Type:Organization
Organization Name:LEWIS COUNTY FIRE PROTECTION DISTRICT NUMBER 15
Other - Org Name:WINLOCK FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-269-2887
Mailing Address - Street 1:PO BOX 708
Mailing Address - Street 2:
Mailing Address - City:WINLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98596-0708
Mailing Address - Country:US
Mailing Address - Phone:360-785-4221
Mailing Address - Fax:
Practice Address - Street 1:609 NW KERRON ST
Practice Address - Street 2:
Practice Address - City:WINLOCK
Practice Address - State:WA
Practice Address - Zip Code:98596-9450
Practice Address - Country:US
Practice Address - Phone:360-785-4221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAMBV.ES.000003963416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport