Organization Active NPI

Integrated Health and Behavior, PLLC

Doing business as Ihb

  • Child & Adolescent Psychiatry Physician
  • Liberty Lake, WA
National Provider Identifier
1902129638
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD00047831 Issued in WA
Legal business name
INTEGRATED HEALTH AND BEHAVIOR, PLLC
Doing business as
Ihb
Practice address
2310 N Molter Rd Ste 105
Liberty Lake, WA 99019-8621
Phone
(509) 891-7867
Fax
(509) 922-0984
NPI assigned
Mar 9, 2010
Last updated
Dec 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Tamara Fisher Wirthlin, JD
Title
Treasurer/Office Manager
Phone
(509) 891-7867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD00047831 WA Primary

Addresses

Primary practice location

2310 N Molter Rd Ste 105
Liberty Lake, WA 99019-8621

Mailing address

2310 N Molter Rd Ste 105
Liberty Lake, WA 99019-8621
Phone (509) 891-7867

Other identifiers 1

IdentifierTypeStateIssuer
1487664603OtherWANPI FOR INDIVIDUAL

Other names 1

  • IHB Doing business as

National Provider Directory

National Provider Directory

Locations

2310 N Molter Rd
Ste 105
Liberty Lake, WA 99019
Phone (509) 891-7867

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1902129638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N MOLTER RD STE 105",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990198621",
            "telephone_number": "509-891-7867",
            "fax_number": "509-922-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N MOLTER RD STE 105",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990198621",
            "telephone_number": "509-891-7867",
            "fax_number": "509-922-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH AND BEHAVIOR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "WIRTHLIN",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "FISHER",
        "authorized_official_title_or_position": "TREASURER/OFFICE MANAGER",
        "authorized_official_telephone_number": "509-891-7867",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00047831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR INDIVIDUAL",
            "identifier": "1487664603",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IHB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.