Provider Demographics
NPI:1396848412
Name:LAMBERT, ELI NATHANIEL (PT)
Entity Type:Individual
Prefix:MR
First Name:ELI
Middle Name:NATHANIEL
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 NE 54TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-2029
Mailing Address - Country:US
Mailing Address - Phone:509-302-8000
Mailing Address - Fax:509-302-8000
Practice Address - Street 1:1499 SE TECH CENTER PL STE 140
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9575
Practice Address - Country:US
Practice Address - Phone:360-859-4886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8444184Medicaid
WA8444184Medicaid
S91597Medicare UPIN