Healthcare Provider Details

I. General information

NPI: 1669398392
Provider Name (Legal Business Name): URGENT MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5622 PACIFIC AVE SE STE 5
LACEY WA
98503-1271
US

IV. Provider business mailing address

5622 PACIFIC AVE SE STE 5
LACEY WA
98503-1271
US

V. Phone/Fax

Practice location:
  • Phone: 360-515-0699
  • Fax: 360-878-9046
Mailing address:
  • Phone: 360-515-0699
  • Fax: 360-878-9046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: ABOBAKKR DIRAR
Title or Position: OWNER
Credential:
Phone: 360-515-0699