Provider Demographics
NPI:1295607604
Name:CAVINESS, LARA (MS-CCC)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:
Last Name:CAVINESS
Suffix:
Gender:F
Credentials:MS-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N BERNARD ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0206
Mailing Address - Country:US
Mailing Address - Phone:509-354-5900
Mailing Address - Fax:
Practice Address - Street 1:800 E PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2900
Practice Address - Country:US
Practice Address - Phone:509-354-3500
Practice Address - Fax:509-354-3535
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL70030373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist