Provider Demographics
NPI:1477785715
Name:CHOI, LAUREN CHARLOTTE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:CHARLOTTE
Last Name:CHOI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20521 BONANZA DR E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391
Mailing Address - Country:US
Mailing Address - Phone:253-353-5334
Mailing Address - Fax:253-251-7362
Practice Address - Street 1:310 NORTH MERIDIAN
Practice Address - Street 2:SUITE 208
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371
Practice Address - Country:US
Practice Address - Phone:253-353-5334
Practice Address - Fax:253-251-7362
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60099194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7136328Medicaid