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LAWRENCE STEPHEN EASTBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
250 FORT ST, NEAH BAY, WA 98357-4003
(360) 645-2233
Mailing address
PO BOX 410, NEAH BAY, WA 98357-0410
(360) 645-2233
(360) 645-2723

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00037646
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010149422
REGENCE BLUE SHIELD OF ID
WA
01
0143577
LABOR & INDUSTRIES
WA
01
202124409
TRICARE
WA
01
4409EA
ASURIS NORTHWEST
WA
05
8253726
WA
01
911216033
TAX ID
WA
01
H19217
STERLING OPTION ONE
WA
01
KY985
BLUE CROSS OF ID
WA
01
P00222485
MEDICARE RAILROAD
WA
Enumeration date
04/28/2006
Last updated
10/10/2025
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