Healthcare Provider Details

I. General information

NPI: 1275079519
Provider Name (Legal Business Name): LAURIN RUSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 HOWARD RD
LANGLEY WA
98260-8530
US

IV. Provider business mailing address

6669 MAXWELTON RD
CLINTON WA
98236-8608
US

V. Phone/Fax

Practice location:
  • Phone: 425-422-5234
  • Fax:
Mailing address:
  • Phone: 425-422-5234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61392880
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: