Provider Demographics
NPI:1811057334
Name:LAWSON, NATASHA KAY (CNM)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:KAY
Last Name:LAWSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 SE STRATUS AVE UNIT 301
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6257
Mailing Address - Country:US
Mailing Address - Phone:503-474-1148
Mailing Address - Fax:503-434-6148
Practice Address - Street 1:2700 SE STRATUS AVE UNIT 301
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6257
Practice Address - Country:US
Practice Address - Phone:503-474-1148
Practice Address - Fax:503-434-6148
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR084058508367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR121574Medicaid
OR033390000OtherREGENCE BLUE CROSS