Individual
LAURA ANN GANHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4011 TALBOT RD S, STE 460, RENTON, WA 98055-5773
(425) 251-5110
(425) 793-7382
Mailing address
PO BOX 59028, RENTON, WA 98058-2028
(425) 251-5110
(425) 793-4707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 60034121
WA
363AM0700X
Medical Physician Assistant
PA60034121
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0247840
L&I
WA
01
—
1478GA
REGENCE
WA
05
—
8537151
—
WA
01
—
P00699281
MED RAILROAD
WA
Enumeration date
03/29/2007
Last updated
11/14/2016
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