Provider Demographics
NPI:1306838032
Name:SAWIN-QUINN, LAURIE (MPT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:SAWIN-QUINN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 ALAMEDA DE LAS PUGAS
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-233-9873
Mailing Address - Fax:
Practice Address - Street 1:2450 EL CAMINO REAL STE 101
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1706
Practice Address - Country:US
Practice Address - Phone:650-565-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 22234174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist