Provider Demographics
NPI:1184647513
Name:STEINLE, ERNEST WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:WILLIAM
Last Name:STEINLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0032
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:
Practice Address - Street 1:380 CHASE AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2924
Practice Address - Country:US
Practice Address - Phone:509-522-5765
Practice Address - Fax:509-522-5558
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35885208600000X
WAMD60538610208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01358852Medicaid
WA2044146Medicaid
OR500685178Medicaid
G45361Medicare UPIN
WAG8940112Medicare PIN