# WILLAMETTE VALLEY TRANSPORT, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609890003
- **Authorized official:** TIMOTHY F MCCLAIN (PRESIDENT)
- **Authorized official phone:** (503) 569-5944

## Contact information

- **Practice address:** 10320 SE HWY 212, CLACKAMAS, OR 97015-9730
- **Practice address phone:** (503) 939-4050
- **Practice address fax:** (503) 939-4050
- **Mailing address:** 1440 13TH ST SE, SALEM, OR 97302-2514
- **Mailing address phone:** (503) 569-7070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | OR | — |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 02/14/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 233330 | — | OR |