LAURA S. GRANTHAM PAC NPI 1609171347

NPI Information

NPI: 1609171347
Provider Name: LAURA S. GRANTHAM, PAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2320 FREEWAY DR
MOUNT VERNON, WA
ZIP 98273
Phone: (360) 428-2550
Get Directions

Laura S. Grantham, PAC is a medical physician assistant in Mount Vernon, WA with 10 years of experience. Laura S. Grantham, PAC NPI is 1609171347. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2320 FREEWAY DR
MOUNT VERNON, WA
ZIP 98273-445
Phone: (360) 428-2550
Fax: (360) 428-6402

The NPI 1609171347 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/11/2011 and was last updated on 9/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2255A2300X	Specialist/Technologist	Athletic Trainer	AL2999	FLORIDA	No
2	363A00000X	Physician Assistant		PA60617391	WASHINGTON	No
3	363AM0700X	Physician Assistant	Medical	PA60617391	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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