MEDICARE: LAXYA SOLUTIONS LLC

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
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1750610036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAXYA SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1542 E LAKE SAMMAMISH PKWY NE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-6639
Country	:	US
Telephone Number	:	425-868-3669
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 E LAKE SAMMAMISH PKWY NE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-6639
Country	:	US
Telephone Number	:	425-868-3669
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. BAGYALAKSHMI DINESH
Credential	:
Telephone Number	:	425-868-3669

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	12/15/2009

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