Organization
INTERLOCAL ORGANIZATION OF LC RURAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT WILTBANK (FIRE CHIEF)
(360) 864-2366
Entity
Organization
Contact information
Practice address
150 N 2ND ST, TOLEDO, WA 98591
(360) 864-2366
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
21D02
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0235205
L&I AND CRIME VICTIMS
WA
05
—
182534
—
OR
05
—
9038480
—
WA
01
—
IN9964
REGENCE
WA
Enumeration date
04/17/2006
Last updated
05/16/2011
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