Individual
EDWARD LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 MEMORIAL ST STE 1, PROSSER, WA 99350-2504
(509) 786-2010
(509) 788-1794
Mailing address
820 MEMORIAL ST STE 1, PROSSER, WA 99350-2504
(509) 786-2010
(509) 788-1794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00029197
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200684
L & I
WA
01
—
1306897681
NPI PROSSER MEMORIAL
—
01
—
8142218
CHPW
WA
05
—
8142218
—
WA
01
—
911019392
COMMERCIAL
—
01
—
9392LA
REGENCE
WA
Enumeration date
08/23/2006
Last updated
03/18/2021
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