1578683413 NPI number — MISS LORI MAE UHLER LMT

Table of content: MISS LORI MAE UHLER LMT (NPI 1578683413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578683413 NPI number — MISS LORI MAE UHLER LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UHLER
Provider First Name:
LORI
Provider Middle Name:
MAE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578683413
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1409
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YELM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98597-1409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-458-7533
Provider Business Mailing Address Fax Number:
360-458-7699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 YELM AVE WEST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
YELM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-458-7533
Provider Business Practice Location Address Fax Number:
360-458-7699
Provider Enumeration Date:
03/31/2007

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: 225700000X , with the licence number:  MA00007001 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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