Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | PO710 | WA |
Y | 213ES0000X | Sports Medicine | PO710 | WA |
NPI | 1144210287 |
---|---|
Provider Name | Dr. Lawrence Michael Maurer |
First Address | Kirkland, WA 98034-3080 |
Second Address | Kirkland, WA 98034-3080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 14/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1117621 | (05) | WA |
U85646 | (02) | WA |