Healthcare Provider Details

I. General information

NPI: 1487729315
Provider Name (Legal Business Name): CECILIA M LAUDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16528 E DESMET CT STE B2100
SPOKANE VALLEY WA
99216-3522
US

IV. Provider business mailing address

PO BOX 31001-4114 PO BOX 31001-4114
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 509-944-9440
  • Fax: 509-227-7070
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-944-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00044206
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: