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NPI Code Detail

MEDICARE: MARY V LASLEY M.D.

MEDICARE: MARY V LASLEY M.D.
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
1207K00000XAllergy & Immunology PhysicianMD00034202WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3030004260OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2LA5439OTHERWAREGENCE

General Provider Information

NPI Number : 1396787925
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY V LASLEY M.D.
Provider Business Mailing Address
First Line : 9725 3RD AVE NE STE 500
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2024
Country : US
Telephone Number : 206-527-1200
Fax Number : 206-527-2514
Provider Business Practice Location Address
First Line : 9725 3RD AVE NE STE 500
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2024
Country : US
Telephone Number : 206-527-1200
Fax Number : 206-527-2514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 09/03/2019

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Directions to “ MARY V LASLEY M.D.” Practice Location

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