Provider Demographics
NPI:1891927422
Name:LAUTT, JEREMY L (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:L
Last Name:LAUTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8752
Mailing Address - Country:US
Mailing Address - Phone:253-964-0991
Mailing Address - Fax:
Practice Address - Street 1:1277 HUDSON ST
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-8752
Practice Address - Country:US
Practice Address - Phone:253-964-0991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-16
Last Update Date:2009-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60012326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor