Provider Demographics
NPI:1144517103
Name:LAWLIS, SHAUNA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:MARIE
Last Name:LAWLIS
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 1:1122 NE 13TH ST # 274
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-4211
Mailing Address - Fax:405-271-6279
Practice Address - Street 1:9505 S STEELE ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-1858
Practice Address - Country:US
Practice Address - Phone:253-597-6800
Practice Address - Fax:253-597-6888
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10039679390200000X
OK328562080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program