=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053220699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAMAS-WASHOUGAL FIRE AUTHORITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2026
-----------------------------------------------------
Last Update Date | 09/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4321 NW PARKER ST
-----------------------------------------------------
City | CAMAS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98607-8810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-867-8790
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4321 NW PARKER ST
-----------------------------------------------------
City | CAMAS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98607-8810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-867-8790
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIVISION CHIEF
-----------------------------------------------------
Name | SHAUN FORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 208-867-8790
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------