Provider Demographics
NPI:1316920580
Name:AIRLIFT NORTHWEST
Entity type:Organization
Organization Name:AIRLIFT NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:COPASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-965-1900
Mailing Address - Street 1:6987 PERIMETER RD S
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-3847
Mailing Address - Country:US
Mailing Address - Phone:206-965-1900
Mailing Address - Fax:206-521-1612
Practice Address - Street 1:6987 PERIMETER RD S
Practice Address - Street 2:SUITE 110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-3847
Practice Address - Country:US
Practice Address - Phone:206-965-1900
Practice Address - Fax:206-521-1612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA42X013416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXMT004690Medicaid
AZ820127Medicaid
AKAA2293Medicaid
OR262945Medicaid
MT0441643Medicaid
WA9028275Medicaid
WA9028275Medicaid
OR262945Medicaid