=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487544540
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRIBALMED PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2025
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 BOREN AVE STE 850
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98104-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-624-0688
-----------------------------------------------------
Fax | 206-624-2432
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 901 BOREN AVE STE 850
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98104-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-624-0688
-----------------------------------------------------
Fax | 206-624-2432
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | ERIKA NICOLE LANZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 206-705-3929
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------