Provider Demographics
NPI:1508835182
Name:ANESTHESIOLOGY INC PS
Entity Type:Organization
Organization Name:ANESTHESIOLOGY INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATE
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-838-8561
Mailing Address - Street 1:104 W 5TH AVE
Mailing Address - Street 2:SUITE 250E
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4880
Mailing Address - Country:US
Mailing Address - Phone:509-838-8561
Mailing Address - Fax:509-835-4058
Practice Address - Street 1:104 W 5TH AVE
Practice Address - Street 2:SUITE 250E
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4880
Practice Address - Country:US
Practice Address - Phone:509-838-8561
Practice Address - Fax:509-835-4058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7165103Medicaid
WAG345100Medicare PIN
WAG000345100Medicare ID - Type Unspecified
WA7165103Medicaid
WAG000345100Medicare PIN