Provider Demographics
NPI:1366561144
Name:LAVADOUR, MEIRA (LMP)
Entity type:Individual
Prefix:
First Name:MEIRA
Middle Name:
Last Name:LAVADOUR
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 MEADOW GLEN LN
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-8680
Mailing Address - Country:US
Mailing Address - Phone:509-994-3361
Mailing Address - Fax:
Practice Address - Street 1:13106 W. SUNSET HWY
Practice Address - Street 2:
Practice Address - City:AIRWAY HEIGHTS
Practice Address - State:WA
Practice Address - Zip Code:99001
Practice Address - Country:US
Practice Address - Phone:509-244-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022733225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist