Provider Demographics
NPI:1013023191
Name:MURPHY, LAURA K (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:K
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:KEATLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19260 SW 65TH AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-5710
Mailing Address - Country:US
Mailing Address - Phone:503-691-9777
Mailing Address - Fax:503-692-6736
Practice Address - Street 1:19260 SW 65TH AVE STE 340
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-5710
Practice Address - Country:US
Practice Address - Phone:503-691-9777
Practice Address - Fax:503-692-6736
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044336208000000X
ORMD25229208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022747Medicaid
H88398Medicare UPIN