Healthcare Provider Details

I. General information

NPI: 1245458264
Provider Name (Legal Business Name): EMMY WASHBURN LAWRASON-KOBOBEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 E 2ND AVE STE 206
DURANGO CO
81301-5474
US

IV. Provider business mailing address

835 E 2ND AVE STE 206
DURANGO CO
81301-5474
US

V. Phone/Fax

Practice location:
  • Phone: 970-828-6500
  • Fax: 970-480-9991
Mailing address:
  • Phone: 970-828-6500
  • Fax: 970-480-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDO157442
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number47700
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: