Organization
LEWIS COUNTY FIRE PROTECTION DISTRICT 11
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD UNDERDAHL (MSO)
(971) 404-8581
Entity
Organization
Contact information
Practice address
800 MAIN STREET, PE ELL, WA 98572
(360) 291-2906
(360) 291-2906
Mailing address
PO BOX 308, PE ELL, WA 98572-0308
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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