Provider Demographics
NPI:1477842367
Name:MAUPIN, LORI ANN (DC)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:MAUPIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:REGNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:12800 NE 4TH ST
Mailing Address - Street 2:APT. LL113
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5051
Mailing Address - Country:US
Mailing Address - Phone:509-710-9446
Mailing Address - Fax:
Practice Address - Street 1:19215 SE 34TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-8829
Practice Address - Country:US
Practice Address - Phone:360-882-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60202569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor