Provider Demographics
NPI:1851309389
Name:STRYKER, LAWRENCE KIMBELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:KIMBELL
Last Name:STRYKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7508 NE VANCOUVER MALL DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6467
Mailing Address - Country:US
Mailing Address - Phone:360-254-6411
Mailing Address - Fax:360-944-5952
Practice Address - Street 1:7508 NE VANCOUVER MALL DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6467
Practice Address - Country:US
Practice Address - Phone:360-254-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00004707122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA206318OtherL & I
WA5397005OtherDSHS