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General NPI Number Information
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NPI Number | 1356282255
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Entity Type | Individual
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Provider Name | MICHEAL DAVID TERLAJE LAUGHLIN
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Gender | Male
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 1202 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-3926
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Country | US
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Telephone | 253-722-1720
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Fax |
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Provider Business Mailing Address
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Address Line | 7632 TACOMA AVE S
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City | TACOMA
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State | WA
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Zip | 98408-5928
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Country | US
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Telephone | 253-389-7857
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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 |
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License Number State |
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