Provider Demographics
NPI:1275588147
Name:SLEEP INSTITUTE OF SPOKANE, PLLC
Entity Type:Organization
Organization Name:SLEEP INSTITUTE OF SPOKANE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-353-3960
Mailing Address - Street 1:324 S SHERMAN ST BLDG A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1461
Mailing Address - Country:US
Mailing Address - Phone:509-353-3960
Mailing Address - Fax:509-343-0134
Practice Address - Street 1:324 S SHERMAN ST STE 6
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1461
Practice Address - Country:US
Practice Address - Phone:509-353-3960
Practice Address - Fax:509-343-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RS0012X
WA602 094 452261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7109622Medicaid
WA470001712OtherRAILROAD MEDICARE
WAGAB23779Medicare PIN