Healthcare Provider Details

I. General information

NPI: 1972609923
Provider Name (Legal Business Name): AMERICAN MEDICAL RESPONSE NORTHWEST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20665 SW BLANTON ST
BEAVERTON OR
97078-1042
US

IV. Provider business mailing address

PO BOX 749667
LOS ANGELES CA
90074-9667
US

V. Phone/Fax

Practice location:
  • Phone: 503-736-3509
  • Fax: 971-394-4034
Mailing address:
  • Phone: 800-913-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY JOSEPH DORN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 833-703-2294