Provider Demographics
NPI:1275674582
Name:MORAN, LAURA K (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:K
Last Name:MORAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 3RD AVE NE STE 201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2023
Mailing Address - Country:US
Mailing Address - Phone:206-367-1345
Mailing Address - Fax:206-367-1366
Practice Address - Street 1:500 COLUMBIA ST NW STE 108
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4447
Practice Address - Country:US
Practice Address - Phone:360-754-0305
Practice Address - Fax:360-596-9304
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1060231H00000X
WALD00001060237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADA9845OtherREGENCE BS
WA7091218Medicaid
WA7091218Medicaid