Individual
MRS. LARYSSA DAWN VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 743-4610
Mailing address
12 BEAVER LN, MONTESANO, WA 98563-9714
(360) 581-0633
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP61195296
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP61195296
LICENSED PRACTICAL NURSE
WA
Enumeration date
03/23/2022
Last updated
03/23/2022
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