Provider Demographics
NPI:1508812041
Name:LAGDAN, SYLVIA GONZALES (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:GONZALES
Last Name:LAGDAN
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 1:7414 91ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-3939
Mailing Address - Country:US
Mailing Address - Phone:253-584-3274
Mailing Address - Fax:
Practice Address - Street 1:3711 PACIFIC AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7800
Practice Address - Country:US
Practice Address - Phone:253-475-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006715363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q21529Medicare UPIN