Provider Demographics
NPI:1306128780
Name:BOWERS, LAURIE CAMERON (MA, LMFT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:CAMERON
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 219TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-3720
Mailing Address - Country:US
Mailing Address - Phone:206-915-1871
Mailing Address - Fax:
Practice Address - Street 1:365 118TH AVE SE
Practice Address - Street 2:SUITE 110
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3557
Practice Address - Country:US
Practice Address - Phone:206-915-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 00001436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist