Healthcare Provider Details

I. General information

NPI: 1851370654
Provider Name (Legal Business Name): LENA FRIEND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LENA FRIEND COBBS M.D.

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 FITZSIMMONS DR
JOINT BASE LEWIS MCCHORD WA
98431-1000
US

IV. Provider business mailing address

9040 FITZSIMMONS DR
JOINT BASE LEWIS MCCHORD WA
98431-1000
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1110
  • Fax:
Mailing address:
  • Phone: 253-968-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number01050420A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: