Provider Demographics
NPI:1518330208
Name:TRI-COUNTY CABULANCE
Entity Type:Organization
Organization Name:TRI-COUNTY CABULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-285-8057
Mailing Address - Street 1:18609 76TH AVE W
Mailing Address - Street 2:SUITE B
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4149
Mailing Address - Country:US
Mailing Address - Phone:425-285-8057
Mailing Address - Fax:425-640-8583
Practice Address - Street 1:18609 76TH AVE W
Practice Address - Street 2:SUITE B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4149
Practice Address - Country:US
Practice Address - Phone:425-285-8057
Practice Address - Fax:425-640-8583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602797674343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)