Healthcare Provider Details

I. General information

NPI: 1396395281
Provider Name (Legal Business Name): MRS. LAUREN PATRICIA ELIZABETH CONSTANTINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LAUREN PATRICIA ELIZABETH CLEMSON

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 SW SCHOLLS FERRY RD APT 28
BEAVERTON OR
97008-5447
US

IV. Provider business mailing address

1218 SE JACQUELINE DR
HILLSBORO OR
97123
US

V. Phone/Fax

Practice location:
  • Phone: 971-727-0301
  • Fax:
Mailing address:
  • Phone: 971-727-0301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: