Provider Demographics
NPI:1891264727
Name:MCGOWAN, LAURA ANN (FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-1054
Mailing Address - Country:US
Mailing Address - Phone:907-545-3049
Mailing Address - Fax:
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-2104
Practice Address - Country:US
Practice Address - Phone:907-545-3049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK141905363LF0000X
WAAP60763367363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily