Individual
LAURA PENALVER-VARGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
319 5TH ST SW, PUYALLUP, WA 98371-5828
(253) 355-5619
Mailing address
505 5TH ST. NE, PUYALLUP, WA 98372
(253) 355-5619
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60385056
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY60385056
STATE PSYCHOLOGIST LICENSE
WA
Enumeration date
11/26/2013
Last updated
02/14/2020
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