Provider Demographics
NPI:1972677300
Name:SPOKANE TRIBAL AMBULANCE
Entity Type:Organization
Organization Name:SPOKANE TRIBAL AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAVONN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:RINNE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:509-258-7766
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:6203 FORD-WELLPINIT RD
Mailing Address - City:WELLPINIT
Mailing Address - State:WA
Mailing Address - Zip Code:99040-0128
Mailing Address - Country:US
Mailing Address - Phone:509-258-7766
Mailing Address - Fax:509-258-9453
Practice Address - Street 1:6203 FORD-WELLPINIT RD
Practice Address - Street 2:
Practice Address - City:WELLPINIT
Practice Address - State:WA
Practice Address - Zip Code:99040
Practice Address - Country:US
Practice Address - Phone:509-258-7766
Practice Address - Fax:509-258-9453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33X033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport