Provider Demographics
NPI:1013634963
Name:ARNOLD, LAVINIA NICOLETTE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:LAVINIA
Middle Name:NICOLETTE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 PHILLIPS RD SW APT 8
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-6303
Mailing Address - Country:US
Mailing Address - Phone:253-292-8512
Mailing Address - Fax:
Practice Address - Street 1:8300 PHILLIPS RD SW APT 8
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-6303
Practice Address - Country:US
Practice Address - Phone:253-292-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61350116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61350116OtherWASHINGTON STATE DEPARTMENT OF HEALTH