Provider Demographics
NPI:1700218682
Name:DANSKIN, LARA ANN (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:LARA
Middle Name:ANN
Last Name:DANSKIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:ANN
Other - Last Name:HEISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1115 SE 164TH AVE
Mailing Address - Street 2:DEPT 358
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9324
Mailing Address - Country:US
Mailing Address - Phone:360-729-1462
Mailing Address - Fax:360-729-3104
Practice Address - Street 1:3015 SQUALICUM PKWY STE 200
Practice Address - Street 2:CENTER FOR ORTHOPEDICS AND SPORTS MEDICINE
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1906
Practice Address - Country:US
Practice Address - Phone:360-733-2092
Practice Address - Fax:360-788-6042
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60398940363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical