Provider Demographics
NPI:1528194248
Name:LAYCO, ANJELIKA A (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANJELIKA
Middle Name:A
Last Name:LAYCO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 NE 77TH CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1171
Mailing Address - Country:US
Mailing Address - Phone:360-772-8058
Mailing Address - Fax:
Practice Address - Street 1:201 SE 124TH AVE
Practice Address - Street 2:# 203
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6066
Practice Address - Country:US
Practice Address - Phone:360-772-8058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 60469590106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist