Provider Demographics
NPI:1154451540
Name:LAWRENCE, GEORGE N (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:N
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3910
Mailing Address - Country:US
Mailing Address - Phone:360-417-1600
Mailing Address - Fax:360-452-4411
Practice Address - Street 1:934 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3910
Practice Address - Country:US
Practice Address - Phone:360-417-1600
Practice Address - Fax:360-452-4411
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2680111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB17299Medicare PIN
WAGAB33548Medicare PIN