Active NPI
American Medical Response Northwest Inc
- Ambulance
- Beaverton, OR
National Provider Identifier
1972609923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- AMERICAN MEDICAL RESPONSE NORTHWEST INC
- Practice address
- 20665 SW Blanton St
Beaverton, OR 97078-1042 - Phone
- (503) 736-3509
- Fax
- (971) 394-4034
- NPI assigned
- Sep 16, 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 Joseph Dorn
- Title
- Chief Administrative Officer
- Phone
- (833) 703-2294
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary | ||
| Land Ambulance | 3416L0300X | |||
| Non-emergency Medical Transport (VAN) | 343900000X |
Addresses
Primary practice location
20665 SW Blanton St
Beaverton, OR 97078-1042
Mailing address
PO Box 749667
Los Angeles, CA 90074-9667
Phone (800) 913-9106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050617000401 | OR | Part B Supplier - Ambulance Service Supplier | 3971545369 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Grants Pass, OR; Portland, OR; Clackamas, OR; Beaverton, OR |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
20665 SW Blanton St
Beaverton, OR 97078
Phone (503) 716-9489
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2286203 | American Medical Response Northwest | Certificate of waiver | Jul 24, 2027 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738022400000",
"number": "1972609923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 749667",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900749667",
"telephone_number": "800-913-9106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20665 SW BLANTON ST",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970781042",
"telephone_number": "503-736-3509",
"fax_number": "971-394-4034"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN MEDICAL RESPONSE NORTHWEST INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-16",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A",
"authorized_official_last_name": "DORN",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
"authorized_official_telephone_number": "833-703-2294"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.