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NPI Code Detail

MEDICARE: LISA WILLMS CP60682706

MEDICARE: LISA WILLMS CP60682706
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCP60682706WA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1730611450
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA WILLMS CP60682706
Provider Business Mailing Address
First Line : PO BOX 4627
Second Line :
City : SPOKANE
State : WA
Zip : 99220-0627
Country : US
Telephone Number : 509-456-5465
Fax Number : 509-456-5710
Provider Business Practice Location Address
First Line : 518 S BROWNE ST
Second Line :
City : SPOKANE
State : WA
Zip : 99204-2315
Country : US
Telephone Number : 509-456-5465
Fax Number : 509-456-5710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2017
Last Update Date : 12/18/2024

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Directions to “ LISA WILLMS CP60682706” Practice Location

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