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General NPI Number Information
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NPI Number | 1942146188
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Entity Type | Organization
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Legal Business Name | EVERGREEN AMBULANCE
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 2330 SE CLATSOP ST
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City | PORTLAND
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State | OR
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Zip | 97202-9001
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Country | US
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Telephone | 503-752-0386
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 SE CLATSOP ST
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City | PORTLAND
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State | OR
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Zip | 97202-9001
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Country | US
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Telephone | 503-752-0386
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | NICHOLAS SEAN HAYES
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Credential | EMT-P
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Telephone | 503-752-0386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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