Provider Demographics
NPI:1821525643
Name:LAURA M CAIN
Entity Type:Organization
Organization Name:LAURA M CAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STUDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:253-334-2179
Mailing Address - Street 1:3815 184TH ST E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98446-2757
Mailing Address - Country:US
Mailing Address - Phone:253-334-2179
Mailing Address - Fax:
Practice Address - Street 1:3815 184TH ST E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446-2757
Practice Address - Country:US
Practice Address - Phone:253-334-2179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center