Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | MD00036612 | WA |
Y | 207K00000X | Allergist & Immunologist | MD21106 | OR |
N | 207KA0200X | Allergist | MD00036612 | WA |
N | 207KA0200X | Allergist | MD21106 | OR |
NPI | 1356346217 |
---|---|
Provider Name | Dr. Laurel Rene Anderson Cowell |
First Address | Vancouver, WA 98686-3029 |
Second Address | Portland, OR 97225-6688 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 15/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
287109 | (05) | OR |
E99908 | (02) |