Provider Demographics
NPI:1467450569
Name:COMMUNITY IN MOTION
Entity Type:Organization
Organization Name:COMMUNITY IN MOTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR / ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KETTWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-735-5715
Mailing Address - Street 1:312 SE STONEMILL DR STE 115
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-3547
Mailing Address - Country:US
Mailing Address - Phone:360-694-6577
Mailing Address - Fax:360-694-1446
Practice Address - Street 1:312 SE STONEMILL DR STE 115
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3547
Practice Address - Country:US
Practice Address - Phone:360-694-6577
Practice Address - Fax:360-694-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600647162347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker