Provider Demographics
NPI:1457684169
Name:SOBIECK, LAURA RENEE (DO)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RENEE
Last Name:SOBIECK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 BOTHELL EVERETT HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1514
Mailing Address - Country:US
Mailing Address - Phone:425-224-3209
Mailing Address - Fax:
Practice Address - Street 1:16000 BOTHELL EVERETT HWY STE 240
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1514
Practice Address - Country:US
Practice Address - Phone:425-224-3209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-13
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10776207Q00000X
WAOP61082249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine