Individual
MS. JENY L LAVORATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1519 S 2ND ST, MOUNT VERNON, WA 98273-4807
(360) 419-9992
Mailing address
1609 S 3RD ST, MOUNT VERNON, WA 98273-4909
(360) 419-9992
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016476
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0165912
STATE OF WA L AND I
WA
Enumeration date
04/08/2008
Last updated
04/08/2008
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