Provider Demographics
NPI:1447613617
Name:LAURANCE, KATHRYN MICHELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:LAURANCE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:EMILINE
Other - Last Name:TAHMOUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2203 172ND ST NE
Mailing Address - Street 2:APT 430
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-4815
Mailing Address - Country:US
Mailing Address - Phone:360-454-6039
Mailing Address - Fax:
Practice Address - Street 1:2203 172ND ST NE
Practice Address - Street 2:APT 430
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-4815
Practice Address - Country:US
Practice Address - Phone:360-454-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60578897175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath