Organization
NORTHWEST WADE CORPORATION
Active
Other names
Community Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUNITA JEAN KAUBLE EMD AND GENERAL MANA (GENERAL MANAGER AND EMERGENCY MEDIC)
(503) 241-7283
Entity
Organization
Contact information
Practice address
9807 SE ASH ST, PORTLAND, OR 97216
(503) 241-7283
(503) 246-2155
Mailing address
PO BOX 16098, PORTLAND, OR 97292
(503) 241-7283
(503) 246-2155
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
383936
OR
343900000X
Non-emergency Medical Transport (VAN)
383936
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149187
—
OR
Enumeration date
04/04/2007
Last updated
09/06/2012
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