Provider Demographics
NPI:1467542233
Name:LAURINO, JAMES ALLEN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:LAURINO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:ALLEN
Other - Last Name:LAURINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2500
Mailing Address - Fax:360-428-6485
Practice Address - Street 1:3823 - 172ND STREET NE
Practice Address - Street 2:CASCADE SKAGIT HEALTH ALLIANCE
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-618-5000
Practice Address - Fax:360-659-9834
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30138207Q00000X
WAMD000246952083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIC47840Medicare UPIN