Provider Demographics
NPI:1396313920
Name:PHILLIPS, LAUREN ELIZABETH
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:PHILLIPS
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:PO BOX 438
Mailing Address - Street 2:
Mailing Address - City:RITZVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99169-0438
Mailing Address - Country:US
Mailing Address - Phone:509-659-4800
Mailing Address - Fax:
Practice Address - Street 1:210 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:RITZVILLE
Practice Address - State:WA
Practice Address - Zip Code:99169-1410
Practice Address - Country:US
Practice Address - Phone:509-659-4800
Practice Address - Fax:509-659-4801
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60658191163WE0003X
WAAP61338051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency