Provider Demographics
NPI:1679367759
Name:VANDERPUY, LAUREN JOELLE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JOELLE
Last Name:VANDERPUY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6328 THOMAS PL SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-6513
Mailing Address - Country:US
Mailing Address - Phone:253-286-8866
Mailing Address - Fax:
Practice Address - Street 1:6328 THOMAS PL SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-6513
Practice Address - Country:US
Practice Address - Phone:253-286-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer