Provider Demographics
NPI:1740410257
Name:PIERCE, LAURA Y (ARNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:Y
Last Name:PIERCE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:KAY
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2420 S UNION AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1322
Mailing Address - Country:US
Mailing Address - Phone:253-272-8148
Mailing Address - Fax:253-404-0506
Practice Address - Street 1:3209 S 23RD ST
Practice Address - Street 2:SUITE 340
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1602
Practice Address - Country:US
Practice Address - Phone:253-272-8148
Practice Address - Fax:253-404-0506
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100522363L00000X
WARN60107157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-100522OtherLICENSE
WAAP60107354OtherWA LICENSE
WACD8128OtherGROUP RR#
WARN60107157OtherLICENSE
WA8851594Medicare PIN
WACD8128OtherGROUP RR#
WAAP60107354OtherWA LICENSE
WAOOO188100Medicare PIN
WARN60107157OtherLICENSE
WAG8851596Medicare UPIN
WAG8885031Medicare PIN
WAG8851597Medicare PIN
WAG8885190Medicare PIN
WAOO1045700Medicare PIN