Provider Demographics
NPI:1568701357
Name:FLOYD, LAUREN ELIZABETH (LAC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 SE 52ND AVE
Mailing Address - Street 2:#2
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3900
Mailing Address - Country:US
Mailing Address - Phone:503-501-7908
Mailing Address - Fax:
Practice Address - Street 1:2225 SE 52ND AVE
Practice Address - Street 2:#2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3900
Practice Address - Country:US
Practice Address - Phone:503-501-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC157174171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist