Healthcare Provider Details

I. General information

NPI: 1215708789
Provider Name (Legal Business Name): LAUREN MARCHESE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6926 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-7254
US

IV. Provider business mailing address

973 BIRCHMONT RD
COLUMBUS OH
43220-4120
US

V. Phone/Fax

Practice location:
  • Phone: 360-993-3000
  • Fax:
Mailing address:
  • Phone: 614-264-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61574402
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.519187
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: