1760638563 NPI number — MEAGHAN ALYS LAWLER LMP

Table of content: MEAGHAN ALYS LAWLER LMP (NPI 1760638563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760638563 NPI number — MEAGHAN ALYS LAWLER LMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWLER
Provider First Name:
MEAGHAN
Provider Middle Name:
ALYS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760638563
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2170
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUMNER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98390-0480
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-840-2313
Provider Business Mailing Address Fax Number:
253-840-6340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6985 COAL CREEK PKWY SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWCASTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98059-3136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-378-0500
Provider Business Practice Location Address Fax Number:
425-378-8168
Provider Enumeration Date:
08/12/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA60025149 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)