Individual
MS. RAYLENE LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1210 W FAIRVIEW ST, COLFAX, WA 99111-9552
(509) 397-4717
(509) 397-3501
Mailing address
756 LANKY RD, COLFAX, WA 99111-8770
(509) 397-4717
(509) 397-3501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004711
WA
363AM0700X
Medical Physician Assistant
PA06967
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0194084
WA STATE DL&I NUMBER
WA
05
—
8373193
—
WA
Enumeration date
11/01/2006
Last updated
03/09/2015
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