Healthcare Provider Details

I. General information

NPI: 1902054687
Provider Name (Legal Business Name): LK HEALTHCARE SYSTEMS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12611 W SUNSET HWY SUITE B
AIRWAY HEIGHTS WA
99001-9427
US

IV. Provider business mailing address

12611 W SUNSET HWY SUITE B
AIRWAY HEIGHTS WA
99001-9427
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-2577
  • Fax:
Mailing address:
  • Phone: 509-747-2577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LORIE A KLAHN
Title or Position: OWNER / MANAGER
Credential: A.R.N.P.
Phone: 509-747-2577