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Individual

LORI D CHANNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
916 N 10TH PL SPC B, RENTON, WA 98057-5540
(425) 391-5770
(425) 391-5771
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD0038604
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184733297
WA
05
8254831
WA
Enumeration date
08/30/2006
Last updated
08/09/2021
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