Provider Demographics
NPI:1255682597
Name:LAKVOLD, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LAKVOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N ARGONNE RD STE B207
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2873
Mailing Address - Country:US
Mailing Address - Phone:253-341-8726
Mailing Address - Fax:
Practice Address - Street 1:505 N ARGONNE RD STE B207
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2873
Practice Address - Country:US
Practice Address - Phone:253-341-8726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health