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General NPI Number Information
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NPI Number | 1467309229
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Entity Type | Individual
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Provider Name | SEBASTIAN VAUGHN EMT
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Gender | Male
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 2336 SW OSAGE ST UNIT 503
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City | PORTLAND
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State | OR
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Zip | 97205-1031
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Country | US
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Telephone | 832-948-4110
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Fax |
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Provider Business Mailing Address
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Address Line | 2336 SW OSAGE ST UNIT 503
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City | PORTLAND
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State | OR
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Zip | 97205-1031
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Country | US
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Telephone | 832-948-4110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 213021
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License Number State | OR
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