Healthcare Provider Details

I. General information

NPI: 1861420275
Provider Name (Legal Business Name): PAULA A LANTSBERGER MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W BOONE AVE STE 268
SPOKANE WA
99201-2346
US

IV. Provider business mailing address

316 W BOONE AVE STE 268
SPOKANE WA
99201-2346
US

V. Phone/Fax

Practice location:
  • Phone: 509-993-4714
  • Fax: 509-537-0485
Mailing address:
  • Phone: 509-993-4714
  • Fax: 509-537-0485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberWA00024148
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00024148
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: