Memorial Physicians, PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

602902835 Issued in WA

Legal business name

MEMORIAL PHYSICIANS, PLLC

Doing business as

Lakeview Spine

Practice address

100 E Jackson Ave
Suite 102
Ellensburg, WA 98926-3692

Phone

(509) 575-6000

Fax

(509) 225-2714

NPI assigned

Apr 4, 2013

Organization subpart

No

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

Authorized official

Name

Timothy Reed

Title

Chief Operating Officer

Phone

(509) 248-7849

Specialties & licenses 1

Addresses

Other names 1

• Lakeview Spine Doing business as

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1306189741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022715",
            "telephone_number": "509-574-6000",
            "fax_number": "509-225-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E JACKSON AVE",
            "address_2": "SUITE 102",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263692",
            "telephone_number": "509-575-6000",
            "fax_number": "509-225-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "509-248-7849"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "602902835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cayla Rae McMahan
• Dale M McPherson, CDP
• Rianne Medcalf
• Ashley Melin, CD(DONA)
• Memorial Physicians, PLLC
• Memorial Physicians, PLLC
• Memorial Physicians, PLLC
• Memorial Physicians, PLLC
• Memorial Physicians, PLLC
• Bianca Mendez

• Physical Medicine & Rehabilitation Physician in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.