Healthcare Provider Details

I. General information

NPI: 1376467340
Provider Name (Legal Business Name): LAUREN MCDOUGALD LMT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 NE 65TH ST
SEATTLE WA
98115-5542
US

IV. Provider business mailing address

2234 MINOR AVE E APT 101
SEATTLE WA
98102-3455
US

V. Phone/Fax

Practice location:
  • Phone: 510-379-6916
  • Fax:
Mailing address:
  • Phone: 510-379-6916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70064120
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: