Basic Information
| Provider Information | |||||||||
| NPI: | 1124266671 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PULLMAN REGIONAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1620 SE SUMMIT CT | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093325106 | ||||||||
| FaxNumber: | 5093345723 | ||||||||
| Practice Location | |||||||||
| Address1: | 1620 SE SUMMIT CT | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093325106 | ||||||||
| FaxNumber: | 5093345723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2009 | ||||||||
| LastUpdateDate: | 05/19/2010 | ||||||||
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| AuthorizedOfficialLastName: | LEEDY | ||||||||
| AuthorizedOfficialFirstName: | LEANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MASSAGE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 9076942844 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LMP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | MA60049092 | WA | Y | Hospitals | Rehabilitation Hospital |
No ID Information.