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General NPI Number Information
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NPI Number | 1174921795
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Entity Type | Organization
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Legal Business Name | ROBERTA D. LIVINGSTON LMT
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Dates
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Enumeration Date | 12/13/2014
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 815 S AUBURN ST
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City | KENNEWICK
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State | WA
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Zip | 99336-5661
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Country | US
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Telephone | 509-947-2572
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Fax |
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Provider Business Mailing Address
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Address Line | 18903 S FINLEY RD
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City | KENNEWICK
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State | WA
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Zip | 99337-8729
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Country | US
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Telephone | 509-947-2572
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERTA D LIVINGSTON
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Credential | LMT
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Telephone | 509-947-2572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 60401637
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License Number State | WA
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