Provider Demographics
NPI:1891730867
Name:WILLIAMS, LAURA E (LMP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2656 E 29TH AVE
Mailing Address - Street 2:PO BOX 31174
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4864
Mailing Address - Country:US
Mailing Address - Phone:509-435-6168
Mailing Address - Fax:509-459-0881
Practice Address - Street 1:2656 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4864
Practice Address - Country:US
Practice Address - Phone:509-435-6168
Practice Address - Fax:509-459-0881
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016143174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist