Healthcare Provider Details

I. General information

NPI: 1518348440
Provider Name (Legal Business Name): LENOUE INTEGRATIVE MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E SHARP AVE
SPOKANE WA
99202-1835
US

IV. Provider business mailing address

301 E SHARP AVE
SPOKANE WA
99202-1835
US

V. Phone/Fax

Practice location:
  • Phone: 509-328-9610
  • Fax: 509-328-5268
Mailing address:
  • Phone: 509-328-9610
  • Fax: 509-328-5268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00001977
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP60393011
License Number StateWA

VIII. Authorized Official

Name: MRS. VERA FISCHER
Title or Position: OFFICE MANAGER
Credential:
Phone: 509-328-9610