Provider Demographics
NPI:1366802282
Name:ROWBERG, LAUREL (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:ROWBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:KRASIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 W 9TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2501
Mailing Address - Country:US
Mailing Address - Phone:509-903-8991
Mailing Address - Fax:509-931-0461
Practice Address - Street 1:315 W 9TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2501
Practice Address - Country:US
Practice Address - Phone:509-389-8909
Practice Address - Fax:509-931-0461
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant