Provider Demographics
NPI:1154504330
Name:NASTRI, LAURA LEE (MHCL)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:NASTRI
Suffix:
Gender:F
Credentials:MHCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BEACH DR
Mailing Address - Street 2:
Mailing Address - City:NORDLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98358-9602
Mailing Address - Country:US
Mailing Address - Phone:360-310-4089
Mailing Address - Fax:855-635-7730
Practice Address - Street 1:101 OAK BAY ROAD
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339
Practice Address - Country:US
Practice Address - Phone:360-310-4089
Practice Address - Fax:855-635-7730
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60328339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2038526Medicaid