Provider Demographics
NPI:1922007848
Name:LAMPERT, AUSTIN C (MD)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:C
Last Name:LAMPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 CAPITAL MALL DR SW
Mailing Address - Street 2:STE 308
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8700
Mailing Address - Country:US
Mailing Address - Phone:360-754-9090
Mailing Address - Fax:360-352-3667
Practice Address - Street 1:3920 CAPITOL MALL DR SW
Practice Address - Street 2:STE 308
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8701
Practice Address - Country:US
Practice Address - Phone:360-754-9090
Practice Address - Fax:360-352-3667
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2012-06-22
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
WAMD00027649207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1117274Medicaid
WAE85078Medicare UPIN
WAGAB34002Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER