Provider Demographics
NPI:1356448203
Name:EHS PULMONARY & CRITICAL CARE, LLC
Entity Type:Organization
Organization Name:EHS PULMONARY & CRITICAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-625-1915
Mailing Address - Street 1:801 W 5TH AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2823
Mailing Address - Country:US
Mailing Address - Phone:509-625-1915
Mailing Address - Fax:509-625-1919
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-625-1915
Practice Address - Fax:509-625-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7054166Medicaid