Healthcare Provider Details
I. General information
NPI: 1750610036
Provider Name (Legal Business Name): LAXYA SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2009
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1542 E LAKE SAMMAMISH PKWY NE
SAMMAMISH WA
98074-6639
US
IV. Provider business mailing address
1542 E LAKE SAMMAMISH PKWY NE
SAMMAMISH WA
98074-6639
US
V. Phone/Fax
- Phone: 425-868-3669
- Fax:
- Phone: 425-868-3669
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
BAGYALAKSHMI
DINESH
Title or Position: OWNER
Credential:
Phone: 425-868-3669