Provider Demographics
NPI:1952811820
Name:PEND OREILLE COUNTY FIRE PROTECTION DISTRICT 4
Entity type:Organization
Organization Name:PEND OREILLE COUNTY FIRE PROTECTION DISTRICT 4
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-447-2476
Mailing Address - Street 1:11 DALKENA ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99156-9768
Mailing Address - Country:US
Mailing Address - Phone:509-447-2476
Mailing Address - Fax:509-447-5530
Practice Address - Street 1:11 DALKENA ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:WA
Practice Address - Zip Code:99156-9768
Practice Address - Country:US
Practice Address - Phone:509-447-2476
Practice Address - Fax:509-447-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY26D033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA