Laurel A Gorham, C.P.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60553305 Issued in WA

Practice address

2205 W Lincoln Ave
Yakima, WA 98902-2437

Phone

(509) 469-6305

NPI assigned

Jul 19, 2006

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Laurel A Hawkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health of Central Washington

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1598764920
  NPD
• Community Health of Central Washington

  dba Highland Clinic

  • Federally Qualified Health Center (FQHC)
  • Tieton, WA
  • NPI 1700255874
  NPD
• Valley Psychological Services

  • Psychologist
  • Ellensburg, WA
  • NPI 1356842785
  NPD
• Yakima Valley Farm Workers Clinic

  dba Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Yakima, WA
  • NPI 1295788602
  NPD
• Yakima Valley Farm Workers Clinic

  dba Mountainview Womens Health Center

  • Federally Qualified Health Center (FQHC)
  • Grandview, WA
  • NPI 1518093830
  NPD
• Mecosta Health Service, Inc.

  • Rural Health Clinic/Center
  • Big Rapids, MI
  • NPI 1184807174
  NPD
• Mecosta Health Services, Inc

  • Family Medicine Physician
  • Big Rapids, MI
  • NPI 1528007952
  NPD
• Yakima Valley Farm Workers Clinic

  dba Community Health Center of Clatskanie

  • Federally Qualified Health Center (FQHC)
  • Clatskanie, OR
  • NPI 1578000345
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1356360499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022437",
            "telephone_number": "509-469-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022437",
            "telephone_number": "509-469-6305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 S 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023115",
            "country_code": "US",
            "telephone_number": "509-573-2598",
            "fax_number": "509-452-5224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1314 SW Kalama Ave",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977563054",
            "country_code": "US",
            "telephone_number": "541-923-5800",
            "fax_number": "541-383-1883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "LAUREL",
        "middle_name": "A",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "201507531NP-PP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60553305",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60553305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2972474/10",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2044559",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500693438",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "HAWKINS",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Todd Nicholas Hamilton Goodenow, APRN
• Patience Goodin
• Charles Meyer Gooss, D.M.D.
• Naveen Prasad Gopalakrishnan Ravikumar, M.D.
• Lisa Gordon
• Melissa R Gorsuch-Clark, M.S.W.
• Deepika S Goshike, MD
• Michael Dean Gostovich
• Steven Gottlieb
• Kamimsa Josephine Goudy, SUDPT

• Nurse Practitioner in Yakima, WA
• Providers in Yakima, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.