Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 61210153 | WA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP61210153 | WA |
NPI | 1588331995 |
---|---|
Provider Name | Lauren Randi Day |
First Address | Tacoma, WA 98405-4933 |
Second Address | Tacoma, WA 98405-4933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2021 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2187836 | (05) | WA |