Individual ProviderLavonna KofstadCounselorBehavioral Health & Social Service ProvidersPractice Address1601 E Fourth Plain Blvd Bldg 17, Vancouver, WA 98661-3717(360) 397-8484PECOS EnrollmentBased on the most recent information from CMS, provider Lavonna Kofstad does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1023596129Provider TypeIndividualFull NameKofstad, LavonnaGenderFemaleSole ProprietorNoEnumeration Date7/31/2018Last Updated7/31/2018Contact InformationPractice LocationPractice Address1601 E Fourth Plain Blvd Bldg 17, Vancouver, WA 98661-3717Phone(360) 397-8484Fax(360) 397-8494Mailing LocationMailing AddressPO Box 1845, Vancouver, WA 98668-1845Phone(360) 397-8484Fax(360) 397-8494Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer