Provider Demographics
NPI:1093277188
Name:CITY OF LAKE OSWEGO
Entity type:Organization
Organization Name:CITY OF LAKE OSWEGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BATTALION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:VACHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-697-7401
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-0369
Mailing Address - Country:US
Mailing Address - Phone:503-635-0275
Mailing Address - Fax:
Practice Address - Street 1:4900 MELROSE ST
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2336
Practice Address - Country:US
Practice Address - Phone:503-697-7401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance