Individual
LARHONDA J. CLAYVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
32018 23RD AVE S, FEDERAL WAY, WA 98003-6022
(253) 839-3030
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30005173
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30005173
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0189548
L&I PIN
WA
01
—
77622U
REGENCE BLUE SHIELD PIN
WA
05
—
9635103
—
WA
Enumeration date
06/26/2006
Last updated
05/29/2008
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