Healthcare Provider Details

I. General information

NPI: 1134064116
Provider Name (Legal Business Name): ERIC CHRISTIAN LASH MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S 900 E
SALT LAKE CITY UT
84105-3208
US

IV. Provider business mailing address

2255 S 300 E APT 346
SOUTH SALT LAKE UT
84115-2995
US

V. Phone/Fax

Practice location:
  • Phone: 801-464-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number14307456-2504
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: