Provider Demographics
NPI:1578787685
Name:CASCADE AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:CASCADE AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:FUITEN
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:503-648-6656
Mailing Address - Street 1:1482 SLATER RD STE A
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-8919
Mailing Address - Country:US
Mailing Address - Phone:360-380-3144
Mailing Address - Fax:360-380-2117
Practice Address - Street 1:1482 SLATER RD STE A
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-8919
Practice Address - Country:US
Practice Address - Phone:360-380-3144
Practice Address - Fax:360-380-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3416L0300X3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA590008018OtherRAIL ROAD MEDICARE
WA9035965Medicaid
WA0042997OtherLABOR & INDUSTRIES
WA590008018OtherRAIL ROAD MEDICARE