Provider Demographics
NPI:1689674244
Name:E.A. SOHN INC., P.S.
Entity Type:Organization
Organization Name:E.A. SOHN INC., P.S.
Other - Org Name:INDIAN TRAIL GERIATRIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-869-7533
Mailing Address - Street 1:1818 W FRANCIS AVE # 385
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6834
Mailing Address - Country:US
Mailing Address - Phone:509-464-1600
Mailing Address - Fax:509-343-9391
Practice Address - Street 1:422 W RIVERSIDE AVE STE 1100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0302
Practice Address - Country:US
Practice Address - Phone:509-464-1600
Practice Address - Fax:509-343-9391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIC A SOHN MD PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-26
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD37099OtherWA LICENSE
IDMD7619OtherIDAHO LICENSE
WA1016357Medicaid
WAGAB33758OtherMEDICARE
WAMD37099OtherWA LICENSE