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NPI Code Detail

MEDICARE: LAVEENA LYNNE WALTERS

MEDICARE: LAVEENA LYNNE WALTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCBT.CB.70128744WA

General Provider Information

NPI Number : 1164369617
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAVEENA LYNNE WALTERS
Provider Business Mailing Address
First Line : 322 N 11TH ST APT 7
Second Line :
City : CHENEY
State : WA
Zip : 99004-2362
Country : US
Telephone Number : 509-425-2854
Fax Number :
Provider Business Practice Location Address
First Line : 16201 E INDIANA AVE STE 3400
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99216-2830
Country : US
Telephone Number : 509-900-3669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2026
Last Update Date : 05/01/2026

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Directions to “ LAVEENA LYNNE WALTERS ” Practice Location

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