MEDICARE: LANA POLINGER MA,LMHC

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
1	101YM0800X	Mental Health Counselor	020703LH00005338	WA

General Provider Information

NPI Number	:	1215089545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANA POLINGER MA,LMHC

Provider Business Mailing Address
First Line	:	14620 SE 16TH PL
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98007-6805
Country	:	US
Telephone Number	:	425-649-1177
Fax Number	:	435-614-2668

Provider Business Practice Location Address
First Line	:	14205 SE 36TH ST
Second Line	:	131
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1596
Country	:	US
Telephone Number	:	425-649-1177
Fax Number	:	425-614-2668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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