Provider Demographics
NPI:1649888793
Name:DIGENNARO, LAUREN E
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:DIGENNARO
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 1:29015 SE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:FALL CITY
Mailing Address - State:WA
Mailing Address - Zip Code:98024-7428
Mailing Address - Country:US
Mailing Address - Phone:484-477-8842
Mailing Address - Fax:
Practice Address - Street 1:2002 156TH AVE NE # 100TH
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3827
Practice Address - Country:US
Practice Address - Phone:610-383-9496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health