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Organization

CITY OF WALLA WALLA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FRED HECTOR (DEPUTY CHIEF OF EMS)
(509) 524-4630
Entity
Organization

Contact information

Practice address
170 N WILBUR AVE, WALLA WALLA, WA 99362-2548
(509) 529-4083
(509) 529-0694
Mailing address
170 N WILBUR AVE, WALLA WALLA, WA 99362-2548
(509) 529-4083
(509) 529-0694

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
36M04
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029454
OREGON MEDICAID
WA
01
12755
WASHINGTON L&I
WA
01
193657900
OFFICE WORKERS COMP
WA
01
590161247
RAILROAD MEDICARE
WA
01
8901205
CRIME VICTIM PROVIDER NUM
WA
05
9150509
WA
01
ITA9023839
INVOLUNTARY
WA
Enumeration date
07/15/2006
Last updated
06/10/2025
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