Individual
LAURIE ELIZABETH BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14434 AMBAUM BLVD SW STE 5, BURIEN, WA 98166-1438
(206) 812-6140
(206) 812-2466
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61156181
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2232047
—
WA
Enumeration date
03/26/2019
Last updated
11/24/2023
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