Basic Information
Provider Information
NPI: 1366454175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAVY
FirstName: LOUISA
MiddleName: V
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KWOK
OtherFirstName: LOUISA
OtherMiddleName: V
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 421
Address2:  
City: LIBERTY LAKE
State: WA
PostalCode: 990190421
CountryCode: US
TelephoneNumber: 5097472455
FaxNumber: 5092277070
Practice Location
Address1: 101 W 8TH AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992042307
CountryCode: US
TelephoneNumber: 5094742895
FaxNumber: 5092277070
Other Information
ProviderEnumerationDate: 08/12/2006
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XMD60116461WAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400XM-10999IDN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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