Healthcare Provider Details

I. General information

NPI: 1144276825
Provider Name (Legal Business Name): TIMOTHY J LESSMEIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W 7TH AVE SUITE 310
SPOKANE WA
99204-2349
US

IV. Provider business mailing address

122 W 7TH AVE SUITE 310
SPOKANE WA
99204-2349
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-7711
  • Fax: 509-747-4664
Mailing address:
  • Phone: 509-838-7711
  • Fax: 509-747-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberM-6403
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD24119
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: