Provider Demographics
NPI:1750354528
Name:CENTRAL PIERCE FIRE & RESCUE
Entity type:Organization
Organization Name:CENTRAL PIERCE FIRE & RESCUE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-538-6400
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 1:17520 22ND AVE E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-4444
Practice Address - Country:US
Practice Address - Phone:253-538-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA27D063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA192061200OtherFEDERAL OWCP
OR232480Medicaid
WA8917130OtherCRIME VICTIMS
CAXMTE06107Medicaid
WA0050285OtherLABOR & INDUSTRIES
WA9038183Medicaid
WAPI2450OtherREGENCE
WA0050285OtherLABOR & INDUSTRIES
OR232480Medicaid