MEDICARE: LORA ANN PLASKON MD

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
1	174400000X	Specialist	MD00038335	WA
2	2088F0040X	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	MD00038335	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00023515	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0202121	OTHER	WA	LABOR & INDUSTRIES
3	1154PL	OTHER	WA	REGENCE

General Provider Information

NPI Number	:	1477500544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORA ANN PLASKON MD

Provider Business Mailing Address
First Line	:	6520 226TH PL SE
Second Line	:	SUITE 205
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-8969
Country	:	US
Telephone Number	:	425-392-8611
Fax Number	:	425-392-9012

Provider Business Practice Location Address
First Line	:	6520 226TH PL SE
Second Line	:	SUITE 205
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-8969
Country	:	US
Telephone Number	:	425-392-8611
Fax Number	:	425-392-9012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	01/19/2015

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Directions to “ LORA ANN PLASKON MD” Practice Location

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