Provider Demographics
NPI:1053610832
Name:TOM, LAURA KATE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KATE
Last Name:TOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW STE 3400
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2965
Mailing Address - Country:US
Mailing Address - Phone:202-877-3300
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW STE 3400
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-20
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD046456208200000X
WAMD60487179208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1053610832Medicaid