Provider Demographics
NPI:1972822658
Name:KOEHN, LAURA ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELLEN
Last Name:KOEHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1115 SE 164TH AVE
Mailing Address - Street 2:DEPT 358
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9324
Mailing Address - Country:US
Mailing Address - Phone:415-738-6217
Mailing Address - Fax:360-788-6872
Practice Address - Street 1:710 BIRCHWOOD, SUITE 201
Practice Address - Street 2:NEUROLOGY ASSOCIATES
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-788-6870
Practice Address - Fax:360-788-6872
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD605720892084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program