Mason Co FPD 11

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

60453257 Issued in WA

Legal business name

MASON CO FPD 11

Doing business as

Mason County Fire District 11

Practice address

130 E Island Lake Rd
Shelton, WA 98584-9189

Phone

(360) 426-1822

Fax

(360) 427-8361

NPI assigned

Apr 25, 2014

Last updated

Aug 27, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brandon S Searles

Title

Fire Chief

Phone

(360) 490-0030

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mason County Fire District 11 Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1396165544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7010",
            "fax_number": "360-394-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E ISLAND LAKE RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985849189",
            "telephone_number": "360-426-1822",
            "fax_number": "360-427-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON CO FPD 11",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "SEARLES",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "360-490-0030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "60453257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I/CRIMEVICTIMS",
            "identifier": "0342121",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039597",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mason County Fire District 11",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Santa Selena Martin-Bautista, SUDPT
• Andrea N Martin, M.D.
• Erin Kim Martin, LISW-S, LICDC
• Erin Martinache, LICSW
• Mary M Knight School District
• Mason County
• Mason County Anesthesia Services PLLC
• Mason County Fire Protection Dist 4
• Mason County Fire Protection District No 16 (Mason County Fire District 16)
• Mason County Medic One, LTD

• Land Ambulance in Shelton, WA
• Providers in Shelton, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.