Provider Demographics
NPI:1053432823
Name:SCHLOSSER, LAWRENCE JOHN
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JOHN
Last Name:SCHLOSSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5501
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98064-5501
Mailing Address - Country:US
Mailing Address - Phone:253-854-1181
Mailing Address - Fax:
Practice Address - Street 1:25821 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7607
Practice Address - Country:US
Practice Address - Phone:253-854-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WASC5413OtherREGENCE-BOEING