| Doctor Name: | LARA DOROTHY MAXWELL |
| NPI Number: | 1013064617 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RC |
| License Number: | RC00052506 |
| Business Practice Address: | 14270 Ne 21st St Bellevue, WA - 980073720 |
| Business Phone Number: | 4256535000 |
| Business Fax Number: | 4256535010 |
| Mailing Address: | 1600 E Olive St, Seattle Mental Health SEATTLE |
| State: | WA |
| Postal Code: | 981222735 |
| Phone Number: | 2063022200 |
| Fax Number: | 2063022210 |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | RC00052506 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |