Provider Demographics
NPI:1528153657
Name:SOUTH KITSAP FIRE AND RESCUE
Entity type:Organization
Organization Name:SOUTH KITSAP FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-871-2411
Mailing Address - Street 1:1974 FIRCREST DR SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-2639
Mailing Address - Country:US
Mailing Address - Phone:360-871-2420
Mailing Address - Fax:360-871-2426
Practice Address - Street 1:1974 FIRCREST DR SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2639
Practice Address - Country:US
Practice Address - Phone:360-871-2420
Practice Address - Fax:360-871-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18D073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9147307Medicaid
WA9147307Medicaid
WA590012817Medicare PIN