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General NPI Number Information
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NPI Number | 1194802249
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Entity Type | Organization
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Legal Business Name | OLYMPIC AMBULANCE SERVICE INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 1011 E FRONT ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-4016
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Country | US
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Telephone | 360-683-3350
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Fax | 360-681-4824
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Provider Business Mailing Address
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Address Line | 601 W HENDRICKSON RD
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City | SEQUIM
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State | WA
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Zip | 98382-3015
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Country | US
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Telephone | 360-683-3350
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Fax | 360-681-4824
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | WENDY L BLACK
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Credential |
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Telephone | 360-683-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 05X03
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License Number State | WA
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