Provider Demographics
NPI:1174024285
Name:CHRIS LAWSON LLC
Entity Type:Organization
Organization Name:CHRIS LAWSON LLC
Other - Org Name:EVERGREEN AUDIOLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:360-892-3445
Mailing Address - Street 1:16209 SE MCGILLIVRAY BLVD STE M
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9034
Mailing Address - Country:US
Mailing Address - Phone:360-892-3445
Mailing Address - Fax:
Practice Address - Street 1:16209 SE MCGILLIVRAY BLVD STE M
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9034
Practice Address - Country:US
Practice Address - Phone:360-892-3445
Practice Address - Fax:360-213-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
14095171OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION