Provider Demographics
NPI:1437326600
Name:ALLAN, LAURA (MA, RC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:ALLAN
Suffix:
Gender:F
Credentials:MA, RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 34TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-3224
Mailing Address - Country:US
Mailing Address - Phone:206-999-1192
Mailing Address - Fax:
Practice Address - Street 1:4444 WOODLAND PARK AVE N
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7429
Practice Address - Country:US
Practice Address - Phone:206-999-1192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00058045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional