Provider Demographics
NPI:1851567887
Name:PIERCE, LAURA (LM CPM)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:MS
Other - First Name:SHAHEEDA
Other - Middle Name:LAURA
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM CPM
Mailing Address - Street 1:PO BOX 13239
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:WA
Mailing Address - Zip Code:98013-0239
Mailing Address - Country:US
Mailing Address - Phone:206-463-6246
Mailing Address - Fax:
Practice Address - Street 1:18017 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-5205
Practice Address - Country:US
Practice Address - Phone:206-463-6246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000261176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife