Provider Demographics
NPI:1265054738
Name:MEADER, LAURA CHRISTINE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CHRISTINE
Last Name:MEADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 71ST AVE W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5143
Mailing Address - Country:US
Mailing Address - Phone:202-288-0036
Mailing Address - Fax:
Practice Address - Street 1:3800 BRIDGEPORT WAY W STE A353
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4495
Practice Address - Country:US
Practice Address - Phone:202-288-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW612203211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical