Healthcare Provider Details

I. General information

NPI: 1205703386
Provider Name (Legal Business Name): LAURA ANN HULL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 PLAZA WAY
KENNEWICK WA
99338-2722
US

IV. Provider business mailing address

759 S NEVADA ST
KENNEWICK WA
99336-4699
US

V. Phone/Fax

Practice location:
  • Phone: 509-221-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.61315799
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: