Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 51613 | MN |
N | 207Q00000X | Family Doctor | MD60749471 | WA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD60749471 | WA |
NPI | 1407910425 |
---|---|
Provider Name | Katheryn J. Lauer |
First Address | Yakima, WA 98909-0787 |
Second Address | Yakima, WA 98902-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1407910425 | (05) | MN |
1407910425 | (05) | WI |
2083894 | (05) | WA |