Healthcare Provider Details

I. General information

NPI: 1902910102
Provider Name (Legal Business Name): LAWRENCE V. MAJOVSKI PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6512 20TH STREET CT W SUITE C
FIRCREST WA
98466-6212
US

IV. Provider business mailing address

6512 20TH STREET CT W SUITE C
FIRCREST WA
98466-6212
US

V. Phone/Fax

Practice location:
  • Phone: 253-572-9917
  • Fax: 253-858-4060
Mailing address:
  • Phone: 253-572-9917
  • Fax: 253-858-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY1655
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: