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NPI Code Detail

MEDICARE: DR. LAURA CHRISTINE PERRY D.O.

MEDICARE: DR. LAURA CHRISTINE PERRY D.O.
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
1207Q00000XFamily Medicine PhysicianOP00000991WA

General Provider Information

NPI Number : 1619025962
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA CHRISTINE PERRY D.O.
Provider Business Mailing Address
First Line : 12610 DES MOINES MEMORIAL DR STE 206
Second Line :
City : SEATTLE
State : WA
Zip : 98168-2287
Country : US
Telephone Number : 206-243-7818
Fax Number : 206-243-0419
Provider Business Practice Location Address
First Line : 12610 DES MOINES MEMORIAL DR STE 206
Second Line :
City : SEATTLE
State : WA
Zip : 98168-2287
Country : US
Telephone Number : 206-243-7818
Fax Number : 206-243-0419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 07/08/2007

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