Provider Demographics
NPI:1952553745
Name:ADAMS, LAURA JANE (LAC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1967 S WASHINGTON ST
Mailing Address - Street 2:#2
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4068
Mailing Address - Country:US
Mailing Address - Phone:303-406-8217
Mailing Address - Fax:
Practice Address - Street 1:2500 NE NEFF RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6015
Practice Address - Country:US
Practice Address - Phone:541-706-6892
Practice Address - Fax:541-706-6813
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU-1427171100000X
CA12652171100000X
390200000X
ORDO207354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No171100000XOther Service ProvidersAcupuncturist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program