Organization
PE ELL AMBULANCE AUXILLARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KRAFCZYK (FIRE CHIEF)
(360) 880-0036
Entity
Organization
Contact information
Practice address
800 N MAIN ST, PE ELL, WA 98572
(360) 520-2046
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
21M05
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0239919
L&I AND CRIME VICTIMS
WA
05
—
9062365
—
WA
01
—
P00840008
RAILROAD MEDICARE
WA
Enumeration date
07/27/2007
Last updated
04/01/2013
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