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Individual
LENORA MARIE IVANEK
Active
Individual
LENORA MARIE IVANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60191143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0274355
STATE L&I
WA
01
—
0287539
STATE L&I
WA
01
—
0287560
STATE L&I
WA
01
—
0287576
STATE L&I
WA
01
—
0301161
STATE L&I
WA
01
—
0301184
STATE L&I
WA
01
—
0304365
STATE L&I
WA
Enumeration date
12/08/2010
Last updated
02/26/2013
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