Provider Demographics
NPI:1790438273
Name:LOMAX, KRISTEN LAUREN (CNA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LAUREN
Last Name:LOMAX
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 S G ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4445
Mailing Address - Country:US
Mailing Address - Phone:253-924-9220
Mailing Address - Fax:
Practice Address - Street 1:1814 S G ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4445
Practice Address - Country:US
Practice Address - Phone:253-924-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604811019291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory