MEDICARE: LAUREN WASKI

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	363LF0000X	Family Nurse Practitioner	NUR-APRN-LIC-192746	MT

General Provider Information

NPI Number	:	1578123162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN WASKI

Provider Business Mailing Address
First Line	:	PO BOX 31001
Second Line	:	4114
City	:	PASADENA
State	:	CA
Zip	:	91110-4114
Country	:	US
Telephone Number	:	406-519-3422
Fax Number	:	406-203-5110

Provider Business Practice Location Address
First Line	:	3017 PAXSON ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-8325
Country	:	US
Telephone Number	:	406-519-3422
Fax Number	:	406-203-5110

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

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	02/26/2026

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Directions to “ LAUREN WASKI ” Practice Location

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