Provider Demographics
NPI:1255110847
Name:LAMJ LLC
Entity type:Organization
Organization Name:LAMJ LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:458-219-2733
Mailing Address - Street 1:PO BOX O
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-0212
Mailing Address - Country:US
Mailing Address - Phone:458-219-2733
Mailing Address - Fax:458-219-2734
Practice Address - Street 1:1070 W ELM AVE
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-2711
Practice Address - Country:US
Practice Address - Phone:458-219-2733
Practice Address - Fax:458-219-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery