Individual
LAURA ELIZABETH WALAWENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-7336
(208) 381-7495
Mailing address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-7336
(208) 381-7495
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35-131822
OH
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
35-131822
OH
2080P0210X
Pediatric Nephrology Physician
Primary
M-17763
ID
208M00000X
Hospitalist Physician
35-131822
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0262588
—
OH
Enumeration date
03/24/2015
Last updated
02/10/2025
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