Individual
LAUREL A GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
2205 W LINCOLN AVE, YAKIMA, WA 98902-2437
(509) 469-6305
Mailing address
2205 W LINCOLN AVE, YAKIMA, WA 98902-2437
(509) 469-6305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60553305
WA
363LP0200X
Pediatric Nurse Practitioner
201507531NP-PP
OR
363LP0200X
Pediatric Nurse Practitioner
AP60553305
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2044559
—
WA
05
—
2972474/10
—
MI
05
—
500693438
—
OR
Enumeration date
07/19/2006
Last updated
02/21/2024
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