Provider Demographics
NPI:1386628568
Name:HALL, LAUREN A
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:A
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2178 GARFIELD AVE SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8770
Mailing Address - Country:US
Mailing Address - Phone:360-871-4555
Mailing Address - Fax:
Practice Address - Street 1:9600 15TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-2820
Practice Address - Country:US
Practice Address - Phone:206-763-2728
Practice Address - Fax:206-762-7630
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00045807183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician