Basic Information
| Provider Information | |||||||||
| NPI: | 1528638970 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIVERLY | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | GABRIELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32329 29TH AVE SW | ||||||||
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| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980232512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2533473506 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3800 JANES RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | ARCATA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955214742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7078221385 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2021 | ||||||||
| LastUpdateDate: | 06/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.