Healthcare Provider Details

I. General information

NPI: 1831341973
Provider Name (Legal Business Name): SUSAN JEAN LAWLER LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 N. WESTGATE BLVD. SUITE 120
TACOMA WA
98406
US

IV. Provider business mailing address

1545 13TH CT
FOX ISLAND WA
98333-9671
US

V. Phone/Fax

Practice location:
  • Phone: 253-686-3014
  • Fax: 253-847-1687
Mailing address:
  • Phone: 253-686-3014
  • Fax: 253-761-7492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60002237
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: