Provider Demographics
NPI:1992134407
Name:LAGAT, AILENE BRIGITTE CADIZ (LMP)
Entity type:Individual
Prefix:MISS
First Name:AILENE
Middle Name:BRIGITTE CADIZ
Last Name:LAGAT
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 BRONSON WAY N STE 120
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5727
Mailing Address - Country:US
Mailing Address - Phone:425-271-4543
Mailing Address - Fax:
Practice Address - Street 1:1222 BRONSON WAY N STE 120
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5727
Practice Address - Country:US
Practice Address - Phone:425-271-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60416458225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist