Provider Demographics
NPI:1831237312
Name:HUPPIN, LAWRENCE Z (DPM)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:Z
Last Name:HUPPIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BROADWAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5395
Mailing Address - Country:US
Mailing Address - Phone:206-344-3808
Mailing Address - Fax:707-549-5023
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:SUITE 220
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5395
Practice Address - Country:US
Practice Address - Phone:206-344-3808
Practice Address - Fax:707-549-5023
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP0000435213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1057769Medicaid
WA480018710OtherRAILROAD MEDICARE
WA0589740001Medicare NSC
WA480018710OtherRAILROAD MEDICARE
WAU11461Medicare UPIN