Provider Demographics
NPI:1043426323
Name:KAYS, PAUL EVAN (LMP)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EVAN
Last Name:KAYS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 W WELLESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1872
Mailing Address - Country:US
Mailing Address - Phone:509-981-2625
Mailing Address - Fax:509-891-1506
Practice Address - Street 1:528 W SINTO AVE
Practice Address - Street 2:ANNEX
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2428
Practice Address - Country:US
Practice Address - Phone:509-981-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018473172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist