Provider Demographics
NPI:1598001299
Name:MUST, LAUREN ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:MUST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MADISON ST STE 1600
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3590
Mailing Address - Country:US
Mailing Address - Phone:206-860-4692
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON ST STE 1600
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3590
Practice Address - Country:US
Practice Address - Phone:206-860-4692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPADA1086363AM0700X
WAPA60794983363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1581862Medicaid
AKK167350Medicare PIN