Provider Demographics
NPI:1285090522
Name:PRECIOUS CARGO WASHINGTON, INC.
Entity type:Organization
Organization Name:PRECIOUS CARGO WASHINGTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENAI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-951-5482
Mailing Address - Street 1:13924 E 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:VERADALE
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9125
Mailing Address - Country:US
Mailing Address - Phone:509-951-5482
Mailing Address - Fax:
Practice Address - Street 1:13924 E 32ND AVE
Practice Address - Street 2:
Practice Address - City:VERADALE
Practice Address - State:WA
Practice Address - Zip Code:99037-9125
Practice Address - Country:US
Practice Address - Phone:509-951-5482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAFRERERE327DU343900000X
WARHOARL256LS343900000X
WALINDERT565MU343900000X
WATRACYK421LD343900000X
WADOHERSR355PL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)