Provider Demographics
NPI:1306911359
Name:MAUGHAN, LORNA (LMP)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:
Last Name:MAUGHAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:LORNA
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3201 DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-2255
Mailing Address - Country:US
Mailing Address - Phone:360-931-4893
Mailing Address - Fax:
Practice Address - Street 1:3425 SE 192ND AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-1466
Practice Address - Country:US
Practice Address - Phone:360-253-7696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor