1851694673 NPI number — Integrated Pain Management, LLC MRS. MICHELE LOUISE HERRING ARNP

Table of content: MRS. MICHELE LOUISE HERRING ARNP (NPI 1851694673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851694673 NPI number — Integrated Pain Management, LLC MRS. MICHELE LOUISE HERRING ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Integrated Pain Management, LLC
Provider Last Name:
HERRING
Provider First Name:
MICHELE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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Provider Other Middle Name:
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NPI Number Information

NPI Number:
1851694673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
507 S Washington
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
992042739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-473-9412
Provider Business Mailing Address Fax Number:
509-808-2180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
507 S Washington
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
992042739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-473-9412
Provider Business Practice Location Address Fax Number:
509-808-2180
Provider Enumeration Date:
12/16/2010

Additional Information

Authorized Official

Authorized Official Last Name:
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Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP60186765 , 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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