Healthcare Provider Details

I. General information

NPI: 1215609730
Provider Name (Legal Business Name): LAUREN GRIMES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11901 NE VILLAGE PLZ STE 261
KIRKLAND WA
98034-5092
US

IV. Provider business mailing address

9742 NE 119TH WAY APT D204
KIRKLAND WA
98034-8945
US

V. Phone/Fax

Practice location:
  • Phone: 425-814-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: