Individual
LOVELY EBAJAN NYLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17 E 8TH AVE, SPOKANE, WA 99202-1201
(509) 474-2151
Mailing address
640 SW GOLDEN HILLS DR APT A202, PULLMAN, WA 99163-6710
(509) 332-9903
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60888834
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11351185900
BLUECROSS BLUESHIELD
WA
Enumeration date
01/19/2022
Last updated
01/19/2022
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