Provider Demographics
NPI:1629424676
Name:LAMB, DAGNIE C (MD, MCR)
Entity Type:Individual
Prefix:
First Name:DAGNIE
Middle Name:C
Last Name:LAMB
Suffix:
Gender:F
Credentials:MD, MCR
Other - Prefix:
Other - First Name:DAGNIE
Other - Middle Name:C
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MCR
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4545 POINT FOSDICK DR # 130
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1700
Practice Address - Country:US
Practice Address - Phone:253-530-8122
Practice Address - Fax:253-530-8139
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR77278207V00000X
WAMD61397857207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology