Provider Demographics
NPI:1629119789
Name:EHMKE, DAVID E (LMP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:EHMKE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 E 51ST AVE
Mailing Address - Street 2:B209
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-8631
Mailing Address - Country:US
Mailing Address - Phone:509-448-3306
Mailing Address - Fax:
Practice Address - Street 1:104 S FREYA ST
Practice Address - Street 2:117A LILAC FLAG BLDG
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4862
Practice Address - Country:US
Practice Address - Phone:509-533-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023081225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist