Provider Demographics
NPI:1750599361
Name:NORTHWEST TRANSPORT
Entity type:Organization
Organization Name:NORTHWEST TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CABULANCE
Authorized Official - Prefix:
Authorized Official - First Name:NORTHWEST
Authorized Official - Middle Name:
Authorized Official - Last Name:TRANSPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-216-5000
Mailing Address - Street 1:22627 85TH PL S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2469
Mailing Address - Country:US
Mailing Address - Phone:253-216-5000
Mailing Address - Fax:253-216-0067
Practice Address - Street 1:22627 85TH PL S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031
Practice Address - Country:US
Practice Address - Phone:253-216-5000
Practice Address - Fax:253-216-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)