Provider Demographics
NPI:1194379024
Name:SEATTLE MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:SEATTLE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FOWSIYO
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:AMIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-712-5568
Mailing Address - Street 1:3221 S 208TH ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98198-4806
Mailing Address - Country:US
Mailing Address - Phone:206-712-5568
Mailing Address - Fax:
Practice Address - Street 1:3221 S 208TH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98198-4806
Practice Address - Country:US
Practice Address - Phone:206-712-5568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)