Provider Demographics
NPI:1497006704
Name:LAWRENCE M. GARGES, MD, PLLC
Entity Type:Organization
Organization Name:LAWRENCE M. GARGES, MD, PLLC
Other - Org Name:ALLERGY & ASTHMA TRI-STATE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD,, PLLC
Authorized Official - Phone:509-751-0600
Mailing Address - Street 1:1207 EVERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2843
Mailing Address - Country:US
Mailing Address - Phone:509-751-0600
Mailing Address - Fax:509-751-8863
Practice Address - Street 1:1207 EVERGREEN CT
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2843
Practice Address - Country:US
Practice Address - Phone:509-751-0600
Practice Address - Fax:509-751-8863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00011322207K00000X, 207R00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty