MEDICARE: DR. JAMES LOGAN LAWRENCE DO

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	207L00000X	Anesthesiology Physician	OP70048871	WA
2	207L00000X	Anesthesiology Physician	DO210001809	DC

General Provider Information

NPI Number	:	1487114195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES LOGAN LAWRENCE DO

Provider Business Mailing Address
First Line	:	1717 S J ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4933
Country	:	US
Telephone Number	:	253-426-6341
Fax Number	:	253-426-6344

Provider Business Practice Location Address
First Line	:	1717 S J ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4933
Country	:	US
Telephone Number	:	253-426-6341
Fax Number	:	253-426-6344

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

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	03/02/2026

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