Healthcare Provider Details

I. General information

NPI: 1881803617
Provider Name (Legal Business Name): SPECIAL MOBILITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 E TRENT AVE
SPOKANE WA
99202-3800
US

IV. Provider business mailing address

2101 NE FLANDERS ST
PORTLAND OR
97232-2811
US

V. Phone/Fax

Practice location:
  • Phone: 509-532-9505
  • Fax:
Mailing address:
  • Phone: 503-232-1440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. FRED STOFFER
Title or Position: GENERAL MANAGER
Credential:
Phone: 503-232-1440