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NPI Code Detail

MEDICARE: MR. LONDA' LAQUIENT WASHINGTON

MEDICARE: MR. LONDA' LAQUIENT WASHINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian301488KY

General Provider Information

NPI Number : 1710812714
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LONDA' LAQUIENT WASHINGTON
Provider Business Mailing Address
First Line : 9007 BIG BOULDER DR
Second Line :
City : LOUISVILLE
State : KY
Zip : 40291-5139
Country : US
Telephone Number : 502-533-1001
Fax Number :
Provider Business Practice Location Address
First Line : 9007 BIG BOULDER DR
Second Line :
City : LOUISVILLE
State : KY
Zip : 40291-5139
Country : US
Telephone Number : 502-533-1001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ MR. LONDA' LAQUIENT WASHINGTON ” Practice Location

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