Provider Demographics
NPI:1710047493
Name:PULMONARY SPECIALISTS, PS
Entity Type:Organization
Organization Name:PULMONARY SPECIALISTS, PS
Other - Org Name:SPOKANE RESPIRATORY CONSULTANTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:GREG
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:509-353-3950
Mailing Address - Street 1:104 W. 5TH AVE.
Mailing Address - Street 2:SUITE 400W.
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4800
Mailing Address - Country:US
Mailing Address - Phone:509-353-3960
Mailing Address - Fax:509-625-7387
Practice Address - Street 1:104 W. 5TH AVE.
Practice Address - Street 2:SUITE 400W.
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4800
Practice Address - Country:US
Practice Address - Phone:509-353-3960
Practice Address - Fax:509-625-7387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001169207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA28537Medicare ID - Type Unspecified