Provider Demographics
NPI:1609247576
Name:LAWS, MICHAEL (LMP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LAWS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6603 NE 55TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-9608
Mailing Address - Country:US
Mailing Address - Phone:360-553-2828
Mailing Address - Fax:
Practice Address - Street 1:17700 SE MILL PLAIN BLVD STE 150
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-7582
Practice Address - Country:US
Practice Address - Phone:360-514-9383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60270550225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist