Basic Information
Provider Information
NPI: 1508412164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHE
FirstName: LEMBI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 N IRON BRIDGE WAY
Address2:  
City: SPOKANE
State: WA
PostalCode: 992024932
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber:  
Practice Location
Address1: 1203 IDAHO ST
Address2:  
City: LEWISTON
State: ID
PostalCode: 835011940
CountryCode: US
TelephoneNumber: 2088488300
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/09/2019
LastUpdateDate: 11/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X55463IDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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