Provider Demographics
NPI:1073571386
Name:ENDOCRINE ASSOCIATES OF SPOKANE PLLC
Entity Type:Organization
Organization Name:ENDOCRINE ASSOCIATES OF SPOKANE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOHLMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-777-5000
Mailing Address - Street 1:910 W 5TH AVE
Mailing Address - Street 2:SUITE 570
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2966
Mailing Address - Country:US
Mailing Address - Phone:509-777-5000
Mailing Address - Fax:509-777-0366
Practice Address - Street 1:910 W 5TH AVE
Practice Address - Street 2:SUITE 570
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2966
Practice Address - Country:US
Practice Address - Phone:509-777-5000
Practice Address - Fax:509-777-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805734600Medicaid
WA7097199Medicaid
WA7097199Medicaid