Provider Demographics
NPI:1861660714
Name:COWLITZ COUNTY FIRE DISTRICT 1
Entity Type:Organization
Organization Name:COWLITZ COUNTY FIRE DISTRICT 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEHNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-225-7462
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 1:160 PINKERTON DR
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9504
Practice Address - Country:US
Practice Address - Phone:360-225-7462
Practice Address - Fax:360-225-1276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA08D013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9061581Medicaid
WA0230488OtherL&I-CRIME VICTIMS
WA0230488OtherL&I-CRIME VICTIMS