Provider Demographics
NPI:1720565237
Name:LA GUIRE, LA REANNA MARIE
Entity Type:Individual
Prefix:
First Name:LA REANNA
Middle Name:MARIE
Last Name:LA GUIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 SW 117TH PL
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-2554
Mailing Address - Country:US
Mailing Address - Phone:206-434-0899
Mailing Address - Fax:206-242-9335
Practice Address - Street 1:1800 112TH AVE NE STE 260E
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2937
Practice Address - Country:US
Practice Address - Phone:425-643-2133
Practice Address - Fax:425-643-2756
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst