Provider Demographics
NPI:1679794374
Name:EHS URGENT CARE
Entity Type:Organization
Organization Name:EHS URGENT CARE
Other - Org Name:FIRSTCARE SOUTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, PRACTICE MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-473-3643
Mailing Address - Street 1:PO BOX 94367
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-6667
Mailing Address - Country:US
Mailing Address - Phone:509-922-9254
Mailing Address - Fax:509-922-7294
Practice Address - Street 1:3016 E 57TH AVE
Practice Address - Street 2:SUITE 24
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7036
Practice Address - Country:US
Practice Address - Phone:509-448-6699
Practice Address - Fax:509-448-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMTS-3787261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7129174Medicaid
WA7129174Medicaid