Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 47700 | CO |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO157442 | OR |
NPI | 1245458264 |
---|---|
Provider Name | Emmy Washburn Lawrason-Kobobel |
First Address | Durango, CO 81301-4775 |
Second Address | Durango, CO 81301-4775 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 18/10/2020 |