Provider Demographics
NPI:1871617209
Name:PAULSEN, LAURI ANNE (MPT)
Entity type:Individual
Prefix:MS
First Name:LAURI
Middle Name:ANNE
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-2641
Mailing Address - Country:US
Mailing Address - Phone:360-537-9441
Mailing Address - Fax:
Practice Address - Street 1:1006 N H ST
Practice Address - Street 2:REHABILITATION SERVICES
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-2521
Practice Address - Country:US
Practice Address - Phone:360-537-6032
Practice Address - Fax:360-537-6026
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist