Individual
DR. EDWARD GREGORY LACLERGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5130 CORPORATE CENTER CT SE, LACEY, WA 98503-5957
(360) 413-8600
(360) 413-8822
Mailing address
5130 CORPORATE CENTER CT SE, LACEY, WA 98503-5957
(360) 413-8600
(360) 413-8822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00014428
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679646848
NPI
WA
05
—
8216004
—
WA
Enumeration date
11/16/2006
Last updated
03/07/2023
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