Healthcare Provider Details

I. General information

NPI: 1396987228
Provider Name (Legal Business Name): LAUREN TONEY QUESNELL M.S., M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 S 336TH ST STE. C
FEDERAL WAY WA
98003-6329
US

IV. Provider business mailing address

533 S 336TH ST STE. C
FEDERAL WAY WA
98003-6329
US

V. Phone/Fax

Practice location:
  • Phone: 253-661-1700
  • Fax:
Mailing address:
  • Phone: 253-661-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number60236661
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD 60236661
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: