Individual
LAUREN ROLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7809 NE VANCOUVER PLAZA DR STE 110, VANCOUVER, WA 98662
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60951172
WA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
FE184720
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD60951172
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2089353
—
WA
Enumeration date
07/23/2014
Last updated
09/17/2019
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