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NPI Code Detail

MEDICARE: LAURA J LENZI 60521601

MEDICARE: LAURA J LENZI 60521601
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist60521601WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1152842010OTHERWAHYGIENE DENTAL

General Provider Information

NPI Number : 1306295514
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA J LENZI 60521601
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number : 206-226-5672
Fax Number :
Provider Business Practice Location Address
First Line : 2781 S 242ND ST
Second Line :
City : DES MOINES
State : WA
Zip : 98198-5166
Country : US
Telephone Number : 206-226-5672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2016
Last Update Date : 06/08/2016

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Directions to “ LAURA J LENZI 60521601” Practice Location

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