Provider Demographics
NPI:1114642162
Name:LAWRENCE, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29634 SW YOUNG WAY
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8579
Mailing Address - Country:US
Mailing Address - Phone:503-250-3708
Mailing Address - Fax:
Practice Address - Street 1:29634 SW YOUNG WAY
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8579
Practice Address - Country:US
Practice Address - Phone:503-250-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula