Provider Demographics
NPI:1790784122
Name:THE NEXT STEP A WOMAN'S BOUTIQUE LLC
Entity Type:Organization
Organization Name:THE NEXT STEP A WOMAN'S BOUTIQUE LLC
Other - Org Name:THE ESSENTIAL WOMAN BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-363-0100
Mailing Address - Street 1:336 S SHERMAN ST
Mailing Address - Street 2:SUITE 'B'
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1449
Mailing Address - Country:US
Mailing Address - Phone:509-363-0100
Mailing Address - Fax:509-363-6500
Practice Address - Street 1:336 S SHERMAN ST
Practice Address - Street 2:SUITE 'B'
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1449
Practice Address - Country:US
Practice Address - Phone:509-363-0100
Practice Address - Fax:509-363-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5171010001Medicare NSC