Provider Demographics
NPI:1689480998
Name:KENT, LANEY (LMT)
Entity type:Individual
Prefix:
First Name:LANEY
Middle Name:
Last Name:KENT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W 4TH AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:TOPPENISH
Mailing Address - State:WA
Mailing Address - Zip Code:98948-1673
Mailing Address - Country:US
Mailing Address - Phone:509-865-5636
Mailing Address - Fax:509-865-2053
Practice Address - Street 1:604 W 4TH AVE UNIT B
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1673
Practice Address - Country:US
Practice Address - Phone:509-865-5636
Practice Address - Fax:509-865-2053
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61637665225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist