Healthcare Provider Details

I. General information

NPI: 1578782991
Provider Name (Legal Business Name): CITY OF OCEAN SHORES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ANCHOR AVE NW
OCEAN SHORES WA
98569-9700
US

IV. Provider business mailing address

PO BOX 909
OCEAN SHORES WA
98569-0909
US

V. Phone/Fax

Practice location:
  • Phone: 360-289-3611
  • Fax:
Mailing address:
  • Phone: 877-200-1191
  • Fax: 336-740-9793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number14M08
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: BRIAN JOHN RITTER
Title or Position: FIRE CHIEF
Credential:
Phone: 360-289-3611