Healthcare Provider Details

I. General information

NPI: 1154472868
Provider Name (Legal Business Name): LAURA R. KAUFMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9505 S STEELE ST
TACOMA WA
98444-1858
US

IV. Provider business mailing address

9505 S STEELE ST
TACOMA WA
98444-1858
US

V. Phone/Fax

Practice location:
  • Phone: 253-597-6800
  • Fax:
Mailing address:
  • Phone: 253-597-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00045515
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00045515
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: