1689719254 NPI number — ERICH L.V. STEINMETZ LMT

Table of content: PREMAL CALLAWAY LPN (NPI 1093163578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689719254 NPI number — ERICH L.V. STEINMETZ LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEINMETZ
Provider First Name:
ERICH
Provider Middle Name:
L.V.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
M

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:
1689719254
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:
4649 CAMPBELL DR SE
Provider Second Line Business Mailing Address:
#247
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97301-6496
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-589-9607
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6395 KEIZER STATION BLVD
Provider Second Line Business Practice Location Address:
103
Provider Business Practice Location Address City Name:
KEIZER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-589-1597
Provider Business Practice Location Address Fax Number:
971-275-1963
Provider Enumeration Date:
02/21/2007

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:  7241 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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