=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083556815
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAUREN JEANNE EADS DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 112 AVENUE D STE A
-----------------------------------------------------
City | SNOHOMISH
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98290-2743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-863-2412
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7820 143RD AVE NE
-----------------------------------------------------
City | LAKE STEVENS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98258-9062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-667-0062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH60430884
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------