Organization
POLK COUNTY FIRE DISTRICT NO.1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN JEAN SHEPARD (OFFIE ADMINISTRATOR)
(503) 838-1510
Entity
Organization
Contact information
Practice address
1800 MONMOUTH ST, NOT APPLICABLE, INDEPENDENCE, OR 97351-9700
(503) 838-1510
(503) 838-1235
Mailing address
1800 MONMOUTH ST, INDEPENDENCE, OR 97351-9700
(503) 838-1510
(503) 838-1235
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2703-06
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119461
—
OR
Enumeration date
11/01/2006
Last updated
08/22/2020
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