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General NPI Number Information
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NPI Number | 1639864374
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Entity Type | Organization
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Legal Business Name | AIRWAY PEDIATRICS, PROFESSIONAL LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 10408 W SUNSET HWY STE 3
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City | SPOKANE
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State | WA
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Zip | 99224-6002
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Country | US
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Telephone | 702-328-2477
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Fax |
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Provider Business Mailing Address
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Address Line | 808 10TH ST
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City | DAVENPORT
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State | WA
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Zip | 99122-9434
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Country | US
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Telephone | 702-328-2477
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Fax | 509-461-5287
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Authorized Official
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Title or Position | OWNER/PRACTICE MANAGER
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Name | MRS. HEATHER LEBO
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Credential |
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Telephone | 702-328-2477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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