Healthcare Provider Details

I. General information

NPI: 1366706343
Provider Name (Legal Business Name): TORY LINCOLN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TORY MAUSETH

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1289
FALL CITY WA
98024-1289
US

IV. Provider business mailing address

PO BOX 1289
FALL CITY WA
98024-1289
US

V. Phone/Fax

Practice location:
  • Phone: 425-224-5203
  • Fax:
Mailing address:
  • Phone: 425-224-5203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60482699
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY60482699
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: