Basic Information
Provider Information
NPI: 1760638563
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAWLER
FirstName: MEAGHAN
MiddleName: ALYS
NamePrefix:  
NameSuffix:  
Credential: LMP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2170
Address2:  
City: SUMNER
State: WA
PostalCode: 983900480
CountryCode: US
TelephoneNumber: 2538402313
FaxNumber: 2538406340
Practice Location
Address1: 6985 COAL CREEK PKWY SE
Address2:  
City: NEWCASTLE
State: WA
PostalCode: 980593136
CountryCode: US
TelephoneNumber: 4253780500
FaxNumber: 4253788168
Other Information
ProviderEnumerationDate: 08/12/2008
LastUpdateDate: 08/12/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000XMA60025149WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

No ID Information.


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