Provider Demographics
NPI:1164591673
Name:PLAWNER, LAUREN L (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:L
Last Name:PLAWNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19515 N CREEK PKWY
Mailing Address - Street 2:#308
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8200
Mailing Address - Country:US
Mailing Address - Phone:425-368-0008
Mailing Address - Fax:425-424-9201
Practice Address - Street 1:19515 N CREEK PKWY
Practice Address - Street 2:#308
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8200
Practice Address - Country:US
Practice Address - Phone:425-368-0008
Practice Address - Fax:425-424-9201
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000466272080P0008X, 2084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8460883Medicaid