Individual
LAUREN EILEEN SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60918239
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP61553983
WA
Other
Enumeration date
07/24/2023
Last updated
05/01/2024
Update your record
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