Individual
LISA JAYNE LECAVALIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
35535 6TH PLACE SW, FEDERAL WAY, WA 98023-8110
(253) 874-5445
Mailing address
PO BOX 24269, FEDERAL WAY, WA 98093-1269
(253) 874-5445
(253) 874-0687
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 60016411
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12116584
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION CERTIFICATION/ MEMBERSHIP
—
01
—
LL 60016411
WASHINGTON STATE DEPARTMENT OF HEALTH SLP LICENSE
WA
Enumeration date
01/12/2011
Last updated
01/12/2011
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