Provider Demographics
NPI:1629153184
Name:AUSTIN C LAMPERT MD INC PC
Entity Type:Organization
Organization Name:AUSTIN C LAMPERT MD INC PC
Other - Org Name:OLYMPIA SLEEP LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-754-9559
Mailing Address - Street 1:3920 CAPITAL MALL DR SW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8701
Mailing Address - Country:US
Mailing Address - Phone:360-754-9559
Mailing Address - Fax:360-352-3667
Practice Address - Street 1:3920 CAPITAL MALL DR SW
Practice Address - Street 2:SUITE 310
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8701
Practice Address - Country:US
Practice Address - Phone:360-754-9559
Practice Address - Fax:360-352-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027649291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1117274Medicaid
WA1117274Medicaid
WAGAB34002Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER