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General NPI Number Information
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NPI Number | 1609501931
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Entity Type | Organization
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Legal Business Name | CITY OF ILWACO
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 301 SPRUCE ST E
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City | ILWACO
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State | WA
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Zip | 98624-9177
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Country | US
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Telephone | 360-642-3188
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 584
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City | ILWACO
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State | WA
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Zip | 98624-0584
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Country | US
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Telephone | 360-642-3145
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Fax | 360-642-3155
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | JEFF ARCHER
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Credential | FIRE CHIEF
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Telephone | 360-518-7814
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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 |
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License Number State |
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