Organization
CITY OF PUYALLUP
Active
Other names
Puyallup Fire & Rescue
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY STEPHENS (MEDICAL OFFICER)
(253) 845-6666
Entity
Organization
Contact information
Practice address
902 7TH ST NW, PUYALLUP, WA 98371-4101
(253) 845-6666
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
27M09
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161618
L&I AND CRIME VICTIMS
WA
01
—
590015201
RAILROAD MEDICARE
WA
05
—
9052945
—
WA
01
—
PU1220
REGENCE
WA
Enumeration date
02/07/2006
Last updated
05/17/2011
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