Active NPI
Willamette Valley Transport, Inc
- Land Ambulance
- Clackamas, OR
National Provider Identifier
1609890003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- WILLAMETTE VALLEY TRANSPORT, INC
- Practice address
- 10320 SE Hwy 212
Clackamas, OR 97015-9730 - Phone
- (503) 939-4050
- Fax
- (503) 939-4050
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy F McClain
- Title
- President
- Phone
- (503) 569-5944
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary | ||
| Non-emergency Medical Transport (VAN) | 343900000X | OR |
Addresses
Primary practice location
10320 SE Hwy 212
Clackamas, OR 97015-9730
Mailing address
1440 13TH St SE
Salem, OR 97302-2514
Phone (503) 569-7070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 233330 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230220000777 | OR | Part B Supplier - Ambulance Service Supplier | 7911379003 | Practice locations: Clackamas, OR |
National Provider Directory
National Provider Directory- Tax ID family
- Willamette Valley Medical Transport
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Salem, OR
- NPI 1538495213
Locations
1440 13th St SE
Salem, OR 97302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1676332800000",
"number": "1609890003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 13TH ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973022514",
"telephone_number": "503-569-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10320 SE HWY 212",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159730",
"telephone_number": "503-939-4050",
"fax_number": "503-939-4050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLAMETTE VALLEY TRANSPORT, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-27",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A",
"authorized_official_last_name": "MCCLAIN",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "503-569-5944"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "OR",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "233330",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.