Provider Demographics
NPI:1154134948
Name:SZKUDLAREK, LAURA FRANCISZKA (LMT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FRANCISZKA
Last Name:SZKUDLAREK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 114TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-9004
Mailing Address - Country:US
Mailing Address - Phone:360-766-0098
Mailing Address - Fax:
Practice Address - Street 1:4525 INTELCO LOOP SE STE A
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5103
Practice Address - Country:US
Practice Address - Phone:360-491-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61643782225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist