Provider Demographics
NPI:1316404361
Name:GARCIA, LAUREN TAYLOR
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:TAYLOR
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4490 SW MUELLER DR APT L304
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97078-8054
Mailing Address - Country:US
Mailing Address - Phone:928-326-6582
Mailing Address - Fax:
Practice Address - Street 1:4490 SW MUELLER DR APT L304
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97078-8054
Practice Address - Country:US
Practice Address - Phone:928-326-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program