Healthcare Provider Details

I. General information

NPI: 1144391145
Provider Name (Legal Business Name): LAURIE S. FOUSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST STE 800
SEATTLE WA
98104-1307
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
81425-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-2700
  • Fax: 206-215-2702
Mailing address:
  • Phone: 206-215-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD00018433
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD 00032085
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: