Provider Demographics
NPI:1174954119
Name:NORTH MASON REGIONAL FIRE AUTHORITY
Entity type:Organization
Organization Name:NORTH MASON REGIONAL FIRE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-275-6711
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528-0277
Mailing Address - Country:US
Mailing Address - Phone:360-275-6711
Mailing Address - Fax:
Practice Address - Street 1:490 NE OLD BELFAIR HWY
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528-9637
Practice Address - Country:US
Practice Address - Phone:360-275-6711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
WA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty