Clallam County Fire District 5

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

05D05 Issued in WA

Legal business name

CLALLAM COUNTY FIRE DISTRICT 5

Practice address

60 Eagle Crest Way
Clallam Bay, WA 98326

Phone

(360) 963-2371

NPI assigned

Dec 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jay D MatsenNPI 1245834100

Title

EMS Billing Supervisor

Phone

(253) 313-3591

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay D Matsen

  • Emergency Medical Services (Emergency Medicine) Physician
  • Forks, WA
  • NPI 1245834100
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1689858722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7030",
            "fax_number": "360-394-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 EAGLE CREST WAY",
            "city": "CLALLAM BAY",
            "state": "WA",
            "postal_code": "98326",
            "telephone_number": "360-963-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLALLAM COUNTY FIRE DISTRICT 5",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "MATSEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EMS BILLING SUPERVISOR",
        "authorized_official_telephone_number": "253-313-3591"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "05D05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0228877",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "611731300",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9038027",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clallam County Public Hospital District No 1
• Thomas Ira Hughes, PA-C, MPAS
• Tanya Jean Hull
• Jessie Jade Paque
• Monique Ariel Peterson

• Land Ambulance in Clallam Bay, WA
• Providers in Clallam Bay, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.