Organization Active NPI

American Medical Response Northwest Inc

  • Ambulance
  • Beaverton, OR
National Provider Identifier
1972609923
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
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

Updated by the provider on Jan 28, 2025

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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 Directory

Locations

20665 SW Blanton St
Beaverton, OR 97078
Phone (503) 716-9489

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2286203American Medical Response Northwest20665 SW Blanton Street, Beaverton, OR 97078Certificate of waiverJul 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.

Verify at the official NPI Registry.