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General NPI Number Information
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NPI Number | 1548728744
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Entity Type | Organization
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Legal Business Name | CARMEN LASBY PLLC
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 2105 112TH AVE NE STE 200
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City | BELLEVUE
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State | WA
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Zip | 98004-2945
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Country | US
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Telephone | 253-642-6358
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60223
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City | RENTON
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State | WA
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Zip | 98058-3223
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Country | US
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Telephone | 253-642-6358
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Fax | 425-207-4932
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. CARMEN DANIELLE LASBY
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Credential | PSYD
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Telephone | 253-642-6358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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