Provider Demographics
NPI:1518138551
Name:INSTITUTE FOR LAPAROSCOPIC SURGERY PLLC
Entity Type:Organization
Organization Name:INSTITUTE FOR LAPAROSCOPIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAUTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-453-7888
Mailing Address - Street 1:1600 116TH AVE NE STE 304
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3057
Mailing Address - Country:US
Mailing Address - Phone:425-453-7888
Mailing Address - Fax:425-453-7899
Practice Address - Street 1:1600 116TH AVE NE STE 304
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3057
Practice Address - Country:US
Practice Address - Phone:425-453-7888
Practice Address - Fax:425-453-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7262587Medicaid
WAAB35385Medicare PIN