Organization
NORTHWEST WADE CORPORATION
Active
Other names
Community Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUNITA J KAUBLE (OWNER)
(503) 241-7283
Entity
Organization
Contact information
Practice address
9807 SE ASH ST, PORTLAND, OR 97216
(503) 241-7283
(503) 246-2155
Mailing address
P.O BOX 16098, PORTLAND, OR 97292
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149187
—
OR
Enumeration date
08/09/2018
Last updated
08/09/2018
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