Provider Demographics
NPI:1063695054
Name:RICHARD E. EHLERS, MD, PC
Entity type:Organization
Organization Name:RICHARD E. EHLERS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-966-2253
Mailing Address - Street 1:3403 POWERHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-1547
Mailing Address - Country:US
Mailing Address - Phone:509-966-2253
Mailing Address - Fax:509-966-3768
Practice Address - Street 1:3403 POWERHOUSE RD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1547
Practice Address - Country:US
Practice Address - Phone:509-966-2253
Practice Address - Fax:509-966-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023762156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8806399Medicare PIN