Provider Demographics
NPI:1629403001
Name:GROWE, LANA LEE (RN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:LEE
Last Name:GROWE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 210TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-4912
Mailing Address - Country:US
Mailing Address - Phone:425-971-9351
Mailing Address - Fax:866-357-0255
Practice Address - Street 1:9415 210TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-4912
Practice Address - Country:US
Practice Address - Phone:425-971-9351
Practice Address - Fax:866-357-0255
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00072935163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse