Active NPI
Lauren Christine Difolco
- Specialist
- Bonney Lake, WA
National Provider Identifier
1619343191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 516288H
- Practice address
- 10920 199TH Ave. CT. E.
Bonney Lake HS,
Bonney Lake, WA 98391 - Phone
- (253) 891-5700
- NPI assigned
- Aug 19, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 516288H | WA | Primary |
Addresses
Primary practice location
10920 199TH Ave. CT. E.
Bonney Lake HS,
Bonney Lake, WA 98391
Mailing address
1221 Mottman Rd SW Apt D203
Tumwater, WA 98512-6391
Phone (720) 425-4641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 516288H | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1619343191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 MOTTMAN RD SW APT D203",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985126391",
"telephone_number": "720-425-4641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10920 199TH AVE. CT. E.",
"address_2": "BONNEY LAKE HS,",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "98391",
"telephone_number": "253-891-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFOLCO",
"first_name": "LAUREN",
"middle_name": "CHRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-19",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "516288H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.