Provider Demographics
NPI:1295759181
Name:FERRIN, LANCE J (MD)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:J
Last Name:FERRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2517 17TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-6311
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:509-755-6580
Practice Address - Street 1:910 W 5TH AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2966
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:509-755-6580
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042068207RG0100X
ORMD157354207RG0100X
IDM-14248207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500646864Medicaid
ORP01097093OtherMEDICARE RAILROAD
OR500646864Medicaid