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NPI Code Detail

MEDICARE: ROSE ANN LAUCK

MEDICARE: ROSE ANN LAUCK
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
1163W00000XRegistered NurseRN00172773WA

General Provider Information

NPI Number : 1952574972
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE ANN LAUCK
Provider Business Mailing Address
First Line : 955 POWELL AVE SW
Second Line : SUITE A
City : RENTON
State : WA
Zip : 98057-2908
Country : US
Telephone Number : 425-277-1311
Fax Number : 425-277-1566
Provider Business Practice Location Address
First Line : 200 S 2ND ST
Second Line :
City : RENTON
State : WA
Zip : 98057-2011
Country : US
Telephone Number : 425-226-5536
Fax Number : 425-226-0354
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2008
Last Update Date : 04/10/2008

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Directions to “ ROSE ANN LAUCK ” Practice Location

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