Provider Demographics
NPI:1326270349
Name:KING, LAUREN JUANITA (DC, FACO)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JUANITA
Last Name:KING
Suffix:
Gender:F
Credentials:DC, FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8318 196TH ST SW
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-6434
Mailing Address - Country:US
Mailing Address - Phone:425-771-8402
Mailing Address - Fax:
Practice Address - Street 1:8318 196TH ST SW
Practice Address - Street 2:1ST FLOOR
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-6434
Practice Address - Country:US
Practice Address - Phone:425-771-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000960111NI0013X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner