Provider Demographics
NPI:1104803485
Name:MASON COUNTY FIRE PROTE
Entity type:Organization
Organization Name:MASON COUNTY FIRE PROTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICH
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-898-4871
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WA
Mailing Address - Zip Code:98592-0039
Mailing Address - Country:US
Mailing Address - Phone:360-898-4871
Mailing Address - Fax:360-898-4870
Practice Address - Street 1:50 E SEATTLE ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:WA
Practice Address - Zip Code:98592-9617
Practice Address - Country:US
Practice Address - Phone:360-898-4871
Practice Address - Fax:360-898-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA23D06146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0172885OtherL&I WORKER'S COMPENSATION
WA8939975OtherL&I CRIME VICTIMS FUND
WA9049115Medicaid
WA8939975OtherL&I CRIME VICTIMS FUND