Provider Demographics
NPI:1740256015
Name:PIERCE COUNTY FIRE DISTRICT 5
Entity type:Organization
Organization Name:PIERCE COUNTY FIRE DISTRICT 5
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIVISION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:EMS DIVISION CHIEF
Authorized Official - Phone:253-851-3111
Mailing Address - Street 1:10222 BUJACICH RD NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8595
Mailing Address - Country:US
Mailing Address - Phone:253-851-3111
Mailing Address - Fax:253-851-9606
Practice Address - Street 1:10222 BUJACICH RD NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8595
Practice Address - Country:US
Practice Address - Phone:253-851-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA27D053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPI6515OtherREGENCE
AKGA135WAMedicaid
WA9030222Medicaid
WA0062914OtherL&I AND CRIME VICTIMS
AKGA135WAMedicaid
WAG001001893Medicare PIN