Organization
LEWIS COUNTY FPD 4
Active
Other names
Morton Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE L HARBAUGH (EMS CAPTAIN)
(360) 496-1283
Entity
Organization
Contact information
Practice address
105 THIRD ST., MORTON, WA 98356
(360) 496-5183
Mailing address
PO BOX 3510, SILVERDALE, WA 98383-3510
(360) 394-7030
(360) 394-7097
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
21D04
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250091
L&I AND CRIME VICTIMS
WA
01
—
616061100
OWCP
WA
05
—
9021882
—
WA
Enumeration date
01/31/2007
Last updated
11/09/2012
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