1619099835 NPI number — CYNTHIA ECKMAN LMP, CR,

Table of content: DR. GAMBRILL B MURRAY MD (NPI 1730272808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619099835 NPI number — CYNTHIA ECKMAN LMP, CR,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ECKMAN
Provider First Name:
CYNTHIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMP, CR,
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:
1619099835
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:
5405 NE 49TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98661-7802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-903-8244
Provider Business Mailing Address Fax Number:
360-828-8730

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5405 NE 49TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98661-7802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-903-8244
Provider Business Practice Location Address Fax Number:
360-828-8730
Provider Enumeration Date:
04/06/2007

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: 174400000X , with the licence number:  MA00023859 , 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)

  • Identifier: MA00023859 . This is a "MASSAGE PRACTITIONER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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