Healthcare Provider Details

I. General information

NPI: 1811417009
Provider Name (Legal Business Name): LAURA LIND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 5TH ST SE STE 3600
PUYALLUP WA
98372-4665
US

IV. Provider business mailing address

1450 5TH ST SE STE 3600
PUYALLUP WA
98372-4665
US

V. Phone/Fax

Practice location:
  • Phone: 253-697-3480
  • Fax:
Mailing address:
  • Phone: 253-697-3480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60769406
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: