Provider Demographics
NPI:1689448870
Name:MEYER, LACEE (ARNP)
Entity type:Individual
Prefix:
First Name:LACEE
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 116TH AVE SE STE 111
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6436
Mailing Address - Country:US
Mailing Address - Phone:425-467-1314
Mailing Address - Fax:425-458-3102
Practice Address - Street 1:50 116TH AVE SE
Practice Address - Street 2:SUIT 111
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6436
Practice Address - Country:US
Practice Address - Phone:425-467-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61488037207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine