1356663710 NPI number — MRS. GINGER LEI SALERA EHKE LAT, ATC

Table of content: MRS. GINGER LEI SALERA EHKE LAT, ATC (NPI 1356663710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356663710 NPI number — MRS. GINGER LEI SALERA EHKE LAT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EHKE
Provider First Name:
GINGER LEI
Provider Middle Name:
SALERA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LAT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALERA
Provider Other First Name:
GINGER LEI
Provider Other Middle Name:
CHIEMI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LAT, ATC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356663710
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11022 SAINT RAFAEL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89141-3808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-756-2130
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6510 HINSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89118-4413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-756-2130
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/25/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , with the licence number:  0506199 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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