Provider Demographics
NPI:1447200167
Name:AMERICAN MEDICAL RESPONSE NORTHWEST INC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE NORTHWEST INC
Other - Org Name:AMERICAN MEDICAL RESPONSE (AMR)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 749667
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-1545
Mailing Address - Country:US
Mailing Address - Phone:800-913-9106
Mailing Address - Fax:
Practice Address - Street 1:1 SE 2ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1000
Practice Address - Country:US
Practice Address - Phone:503-239-0389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0087429OtherWA STATE DEPT OF LABOR
OR227896Medicaid
OR194135300OtherUS DOL - FECA
OR214494Medicaid
OROR0000D100173OtherSECTION 1011
WA1447200167Medicaid
WA1447200167Medicaid
WA1447200167Medicaid
OR194135300OtherUS DOL - FECA