Provider Demographics
NPI:1073868410
Name:WALDRON, LAUREN JANE (PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JANE
Last Name:WALDRON
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:JANE
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17307 SE 272ND ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5304
Mailing Address - Country:US
Mailing Address - Phone:425-690-3521
Mailing Address - Fax:425-690-9521
Practice Address - Street 1:17307 SE 272ND ST STE 126
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5306
Practice Address - Country:US
Practice Address - Phone:425-690-3521
Practice Address - Fax:256-909-5214
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60545324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8941469Medicare PIN
WAG8941470Medicare PIN