Provider Demographics
NPI:1093961039
Name:TLC HEALTH & EDUCATION SERVICES
Entity Type:Organization
Organization Name:TLC HEALTH & EDUCATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:W
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:509-466-9198
Mailing Address - Street 1:10015 N DIVISION
Mailing Address - Street 2:#101
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1387
Mailing Address - Country:US
Mailing Address - Phone:509-466-9198
Mailing Address - Fax:509-462-0407
Practice Address - Street 1:10015 N DIVISION
Practice Address - Street 2:#101
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1387
Practice Address - Country:US
Practice Address - Phone:509-466-9198
Practice Address - Fax:509-462-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001198363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9601394Medicaid
WA9652215Medicaid
WA9652215Medicaid
WAG8802205Medicare PIN