Provider Demographics
NPI:1568722361
Name:HAGER, LAUREN E (LMP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:HAGER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4218
Mailing Address - Country:US
Mailing Address - Phone:360-671-1710
Mailing Address - Fax:360-671-1605
Practice Address - Street 1:2000 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4218
Practice Address - Country:US
Practice Address - Phone:360-671-1710
Practice Address - Fax:360-671-1605
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60239979225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist