Organization
GRANT COUNTY FIRE DISTRICT NO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER HANSEN (FIRE CHIEF)
(509) 765-3175
Entity
Organization
Contact information
Practice address
11058 NELSON ROAD NE, MOSES LAKE, WA 98837-8812
(509) 765-3175
(509) 765-3550
Mailing address
4251 KIPLING STREET, SUITE 200, WHEATRIDGE, CO 80033
(303) 329-9044
(303) 336-3166
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
13M18
WA
341600000X
Ambulance
13D05
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163229
LABOR & INDUSTRIES
WA
05
—
6053257
—
WA
Enumeration date
01/09/2006
Last updated
09/11/2025
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