Healthcare Provider Details

I. General information

NPI: 1568325314
Provider Name (Legal Business Name): NATASHA LANKFORD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12009 NE 99TH ST STE 1430
VANCOUVER WA
98682-2497
US

IV. Provider business mailing address

12009 NE 99TH ST STE 1430
VANCOUVER WA
98682-2497
US

V. Phone/Fax

Practice location:
  • Phone: 360-980-1733
  • Fax:
Mailing address:
  • Phone: 360-980-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB61657429
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: