Healthcare Provider Details
I. General information
NPI: 1447200167
Provider Name (Legal Business Name): AMERICAN MEDICAL RESPONSE NORTHWEST INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 SE 2ND AVE
PORTLAND OR
97214-1000
US
IV. Provider business mailing address
PO BOX 749667
LOS ANGELES CA
90074-1545
US
V. Phone/Fax
- Phone: 503-239-0389
- Fax:
- Phone: 800-913-9106
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIMOTHY
JOSEPH
DORN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 833-703-2294