NPIMap

Organization Active NPI

Lutheran Community Services Northwest

  • Community/Behavioral Health Agency
  • Spokane, WA
National Provider Identifier
1609900307
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
602 128 998 Issued in WA
Legal business name
LUTHERAN COMMUNITY SERVICES NORTHWEST
Practice address
210 W Sprague Ave
Spokane, WA 99201-3627
Phone
(509) 747-8224
Fax
(509) 747-0609
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Authorized official

Name
Mr. David Bruxer, LICSW
Title
Cqi Director
Phone
(509) 747-8224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 602 128 998 WA Primary

Addresses

Primary practice location

210 W Sprague Ave
Spokane, WA 99201-3627

Mailing address

210 W Sprague Ave
Spokane, WA 99201-3627
Phone (509) 747-8224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050408000542 WA Part B Supplier - Clinic/Group Practice 1254237522 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spokane, WA; Seatac, WA; Kennewick, WA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Community Services North West17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1609900307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013627",
            "telephone_number": "509-747-8224",
            "fax_number": "509-747-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013627",
            "telephone_number": "509-747-8224",
            "fax_number": "509-747-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN COMMUNITY SERVICES NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "BRUXER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CQI DIRECTOR",
        "authorized_official_telephone_number": "509-747-8224",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "602 128 998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.