MEDICARE: MS. LAVONA LA'THENA HOOD

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
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1932400934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAVONA LA'THENA HOOD

Provider Business Mailing Address
First Line	:	1024 CENTRAL AVE N APT J15
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98032-3079
Country	:	US
Telephone Number	:	206-478-6838
Fax Number	:

Provider Business Practice Location Address
First Line	:	1024 CENTRAL AVE N APT J15
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98032-3079
Country	:	US
Telephone Number	:	206-478-6838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2010
Last Update Date	:	11/06/2010

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Directions to “ MS. LAVONA LA'THENA HOOD ” Practice Location

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