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General NPI Number Information
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NPI Number | 1235629072
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Entity Type | Individual
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Provider Name | AUBREY CHRISTINE LANE LMFTA
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Gender | Female
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | LARCH COUNSELING 15315 1ST AVENUE NORTHEAST #205-A
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City | DUVALL
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State | WA
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Zip | 98019
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Country | US
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Telephone | 425-200-0130
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Fax |
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Provider Business Mailing Address
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Address Line | 45716 SE MT SI RD
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City | NORTH BEND
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State | WA
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Zip | 98045-8741
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Country | US
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Telephone | 206-962-9007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | CAAR.CG.60578901
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License Number State | WA
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