Provider Demographics
NPI:1093278780
Name:VOGT, LAUREN (LMT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:VOGT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 KING ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6263
Mailing Address - Country:US
Mailing Address - Phone:360-306-8073
Mailing Address - Fax:360-783-6761
Practice Address - Street 1:1316 KING ST STE 3
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6263
Practice Address - Country:US
Practice Address - Phone:360-306-8073
Practice Address - Fax:360-783-6761
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60921904225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist