Provider Demographics
NPI:1487849121
Name:LAWRENCE W SNOW, MD INC.PS
Entity type:Organization
Organization Name:LAWRENCE W SNOW, MD INC.PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-235-9981
Mailing Address - Street 1:PO BOX 94032
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-9432
Mailing Address - Country:US
Mailing Address - Phone:425-235-9981
Mailing Address - Fax:425-271-1217
Practice Address - Street 1:17910 TALBOT RD S STE 100
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6237
Practice Address - Country:US
Practice Address - Phone:425-235-9981
Practice Address - Fax:425-271-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00012944207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA207X00000XOtherTAXONOMY
WA1820109Medicaid
WADB1622OtherMEDICARE UNSPECIFIED
WA5307640001Medicare NSC
WAA05672Medicare UPIN
AB20127Medicare PIN