Healthcare Provider Details

I. General information

NPI: 1619021813
Provider Name (Legal Business Name): METRO WEST AMBULANCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 NE DAWSON CREEK DR
HILLSBORO OR
97124-5797
US

IV. Provider business mailing address

609 NW COAST ST
NEWPORT OR
97365-3409
US

V. Phone/Fax

Practice location:
  • Phone: 503-648-6658
  • Fax: 503-693-3216
Mailing address:
  • Phone: 503-648-6658
  • Fax: 503-693-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES D FUITEN
Title or Position: PRESIDENT
Credential:
Phone: 503-648-6658