Individual
IMKA LAVINDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4700 PT FOSDICK DR NW, #211, GIG HARBOR, WA 98335
(253) 851-5665
(253) 627-0855
Mailing address
316 MARTIN LUTHER KING JR WAY, #212, TACOMA, WA 98405
(253) 383-5777
(253) 627-0855
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OP00001745
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8283335
—
WA
Enumeration date
10/05/2006
Last updated
09/21/2012
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