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Individual

LAUREN REBECCA WAXWING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
505 UNION AVE SE, OLYMPIA, WA 98501
(360) 943-0780
Mailing address
505 UNION AVE SE, OLYMPIA, WA 98501-1473
(360) 943-0780

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC60883783
WA
106H00000X
Marriage & Family Therapist
Primary
LF61111568
WA

Other

Enumeration date
01/10/2018
Last updated
01/25/2021
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