Individual
LAUREN C PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
111 MARKET ST NE, SUITE 108, OLYMPIA, WA 98501-1008
(360) 754-7085
(360) 754-3671
Mailing address
5210 CORPORATE CENTER LOOP SE, SUITE D, LACEY, WA 98503-5952
(360) 455-8155
(360) 455-1655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23625
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237127
L&I
WA
01
—
2877PA
REGENCE
WA
01
—
3989PA
REGENCE
WA
01
—
4352PA
REGENCE
WA
01
—
6275PA
REGENCE
WA
01
—
6572PA
MEDICARE
WA
01
—
8515686
DSHS
WA
01
—
G8874834
MEDICARE
WA
Enumeration date
10/26/2007
Last updated
01/16/2009
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