Healthcare Provider Details

I. General information

NPI: 1982523510
Provider Name (Legal Business Name): TRI MED TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 W SUNRISE PR NW
BENTON CITY WA
99320-6774
US

IV. Provider business mailing address

10403 DUNE LAKE LOOP SE
MOSES LAKE WA
98837-9083
US

V. Phone/Fax

Practice location:
  • Phone: 509-231-7423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: STACIE PACK
Title or Position: OWNER
Credential:
Phone: 509-231-7433