Provider Demographics
NPI:1811289747
Name:CHESLEY, LAURA SHERMAN (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:SHERMAN
Last Name:CHESLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MADIGAN PEDIATRICS
Mailing Address - Street 2:9040 A REID ST.
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1910
Mailing Address - Country:US
Mailing Address - Phone:253-968-1110
Mailing Address - Fax:
Practice Address - Street 1:9040 A REID ST.
Practice Address - Street 2:MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1910
Practice Address - Country:US
Practice Address - Phone:253-968-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60456381208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics