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General NPI Number Information
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NPI Number | 1245338201
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Entity Type | Individual
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Provider Name | LAURA S KOK PA
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12607 SE MILL PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98684-6055
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Country | US
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Telephone | 360-418-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 6017 HIGHLAND DR
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City | VANCOUVER
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State | WA
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Zip | 98661-7143
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Country | US
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Telephone | 360-693-5350
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | WA PA10002629
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License Number State | WA
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