Provider Demographics
NPI:1306923354
Name:LAURANCE, JOAN (NO)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:LAURANCE
Suffix:
Gender:F
Credentials:NO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 12TH STREET
Mailing Address - Street 2:STE 3
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:541-386-4844
Mailing Address - Fax:541-386-7237
Practice Address - Street 1:1940 12TH STREET
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-386-4844
Practice Address - Fax:541-386-7237
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR623175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath