Doctor Name: | DR. KENNETH BOYD LAUREN |
NPI Number: | 1376575431 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD00013217 |
Business Practice Address: | 15005 Pacific Ave Spanaway General Medical Clinic Tacoma, WA - 98444 |
Business Phone Number: | 2535373724 |
Business Fax Number: | 2535376425 |
Mailing Address: | 15005 Pacific Ave, Spanaway General Medical Clinic TACOMA |
State: | WA |
Postal Code: | 98444 |
Phone Number: | 2535373724 |
Fax Number: | 2535376425 |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD00013217 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |