Individual
MADELINE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1040 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-4610
Mailing address
PO BOX 188, DUFUR, OR 97021-0188
(303) 521-3909
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202006400NP-PP
OR
390200000X
Student in an Organized Health Care Education/Training Program
390200000X
OR
Other
Enumeration date
05/17/2020
Last updated
03/30/2022
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