Provider Demographics
NPI:1275985616
Name:SOWASH, LAUREN (OD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:SOWASH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8007 W 151ST ST
Mailing Address - Street 2:STE 102
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2115
Mailing Address - Country:US
Mailing Address - Phone:720-962-6906
Mailing Address - Fax:
Practice Address - Street 1:355 S WADSWORTH BLVD UNIT D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3136
Practice Address - Country:US
Practice Address - Phone:720-962-6906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3235152W00000X
KS2124152W00000X
AZ2139152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometrist