Individual
DR. LAURA KAY PENNAVARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
568 NE SAVANNAH DR, BEND, OR 97701-4866
(541) 516-1705
(541) 833-2619
Mailing address
568 NE SAVANNAH DR STE 1, BEND, OR 97701-4866
(541) 516-1705
(541) 833-2619
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A82578
CA
207Q00000X
Family Medicine Physician
Primary
MD156899
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD156899
STATE MEDICAL LICENSE
OR
Enumeration date
08/14/2006
Last updated
04/23/2025
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