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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