Individual provider Active NPI

Charles W Laudenbach, MD

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1255324638
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00033526 Issued in WA
Practice address
400 E 5TH Ave
Spokane, WA 99202-1334
Phone
(509) 838-2531
NPI assigned
Aug 31, 2005
Last updated
Nov 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00033526 WA Primary

Addresses

Primary practice location

400 E 5TH Ave
Spokane, WA 99202-1334

Mailing address

PO Box 3649
Spokane, WA 99220-3649
Phone (509) 838-2531

Other identifiers 1

IdentifierTypeStateIssuer
8188617MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000854 WA Practitioner - Internal Medicine 0143138131 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00033526WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1255324638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649",
            "telephone_number": "509-838-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021334",
            "telephone_number": "509-838-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDENBACH",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00033526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8188617",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.