Basic Information
Provider Information
NPI: 1003003153
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRISON
FirstName: LAURA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1145 BROADWAY
Address2:  
City: SEATTLE
State: WA
PostalCode: 981224201
CountryCode: US
TelephoneNumber: 2063291760
FaxNumber: 2063255150
Practice Location
Address1: 904 7TH AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981041132
CountryCode: US
TelephoneNumber: 2068604691
FaxNumber: 2063291261
Other Information
ProviderEnumerationDate: 10/02/2007
LastUpdateDate: 04/09/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000XMD60421884WAY Allopathic & Osteopathic PhysiciansDermatology 
2085R0202XML20009098WAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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