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Organization

MASON COUNTY FIRE PROTECTION DIST 4

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA SUE BRENGAN (OFFICE MANAGER)
(360) 426-7222
Entity
Organization

Contact information

Practice address
2970 SE ARCADIA RD, SHELTON, WA 98584-9324
(360) 426-7222
(360) 427-6120
Mailing address
2970 SE ARCADIA RD, SHELTON, WA 98584-9324
(360) 426-7222
(360) 427-6120

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
23D04
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0173322
L&I WORKERS COMPENSATION
WA
05
9053190
WA
Enumeration date
12/28/2005
Last updated
06/20/2012
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