Provider Demographics
NPI:1073884102
Name:LARRY W. EINSPAHR, M.D., P.S.
Entity Type:Organization
Organization Name:LARRY W. EINSPAHR, M.D., P.S.
Other - Org Name:LARRY W. EINSPAHR M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:EINSPAHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-999-2486
Mailing Address - Street 1:5400 CARILLON PT BLDG 5000
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7357
Mailing Address - Country:US
Mailing Address - Phone:206-999-2486
Mailing Address - Fax:360-871-1942
Practice Address - Street 1:5400 CARILLON PT BLDG 5000
Practice Address - Street 2:4TH FLOOR
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7357
Practice Address - Country:US
Practice Address - Phone:206-999-2486
Practice Address - Fax:360-871-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 000169032084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1346305257OtherNATIONAL PROVIDER IDENTIFICATION NUMBER (NPI)
WA000101420OtherMEDICARE IDENTIFICATION NUMBER