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General NPI Number Information
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NPI Number | 1750372553
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Entity Type | Organization
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Legal Business Name | WESTERN LANE AMBULANCE DISTRICT
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 410 9TH ST
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City | FLORENCE
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State | OR
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Zip | 97439-7398
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Country | US
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Telephone | 541-997-9614
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Fax | 541-997-2995
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Provider Business Mailing Address
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Address Line | PO BOX 3510
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City | SILVERDALE
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State | WA
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Zip | 98383-3510
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Country | US
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Telephone | 360-394-7020
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Fax | 360-394-7099
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Authorized Official
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Title or Position | DEPUTY CHIEF
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Name | ROBERT CHANCE
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Credential |
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Telephone | 541-997-3212
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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 | 2003-05
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License Number State | OR
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