Provider Demographics
NPI:1407986904
Name:ECKHARDT, JANYCE LEE (LMT)
Entity Type:Individual
Prefix:
First Name:JANYCE
Middle Name:LEE
Last Name:ECKHARDT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18511 N LITTLE SPOKANE DR
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9251
Mailing Address - Country:US
Mailing Address - Phone:509-467-3797
Mailing Address - Fax:509-838-5779
Practice Address - Street 1:1625 W 4TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-1720
Practice Address - Country:US
Practice Address - Phone:509-624-5855
Practice Address - Fax:509-838-5779
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004807225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist