# POLK COUNTY FIRE DISTRICT NO.1

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376620799
- **Authorized official:** SUSAN JEAN SHEPARD (OFFIE ADMINISTRATOR)
- **Authorized official phone:** (503) 838-1510

## Contact information

- **Practice address:** 1800 MONMOUTH ST, NOT APPLICABLE, INDEPENDENCE, OR 97351-9700
- **Practice address phone:** (503) 838-1510
- **Practice address fax:** (503) 838-1235
- **Mailing address:** 1800 MONMOUTH ST, INDEPENDENCE, OR 97351-9700
- **Mailing address phone:** (503) 838-1510
- **Mailing address fax:** (503) 838-1235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 2703-06 | OR | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 119461 | — | OR |