Basic Information
Provider Information
NPI: 1407239627
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAMSIN
FirstName: CHARMAINE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1717 S J ST
Address2:  
City: TACOMA
State: WA
PostalCode: 984054933
CountryCode: US
TelephoneNumber: 2534266341
FaxNumber: 2534266344
Practice Location
Address1: 1717 S J ST
Address2:  
City: TACOMA
State: WA
PostalCode: 984054933
CountryCode: US
TelephoneNumber: 2534266341
FaxNumber: 2534266344
Other Information
ProviderEnumerationDate: 07/07/2015
LastUpdateDate: 12/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XOP60833106WAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XUO4436FLN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XOP60833106WAY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
210410305WA MEDICAID


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