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NPI Code Detail

MEDICARE: DOMINIQUE LASTAR ASHLEY

MEDICARE:   DOMINIQUE LASTAR ASHLEY
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
1106S00000XBehavior TechnicianCB70108657WA

General Provider Information

NPI Number : 1942158829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE LASTAR ASHLEY
Provider Business Mailing Address
First Line : 3821 W WHISTALKS WAY APT 303
Second Line :
City : SPOKANE
State : WA
Zip : 99224-5215
Country : US
Telephone Number : 509-216-5377
Fax Number :
Provider Business Practice Location Address
First Line : 1719 N ATLANTIC ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-4804
Country : US
Telephone Number : 509-216-5377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ DOMINIQUE LASTAR ASHLEY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.