Provider Demographics
NPI:1073558342
Name:LENOUE, PHILIP A (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:A
Last Name:LENOUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E SHARP AVE
Mailing Address - Street 2:B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1835
Mailing Address - Country:US
Mailing Address - Phone:509-328-9610
Mailing Address - Fax:509-328-5268
Practice Address - Street 1:301 E SHARP AVE
Practice Address - Street 2:B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1835
Practice Address - Country:US
Practice Address - Phone:509-328-9610
Practice Address - Fax:509-328-5268
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2000370Medicaid
WA000300881Medicare ID - Type Unspecified
WA2000370Medicaid