Healthcare Provider Details

I. General information

NPI: 1093623290
Provider Name (Legal Business Name): LISA TRIFILETTI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 HARBOUR PL STE 204
MUKILTEO WA
98275-4749
US

IV. Provider business mailing address

9800 HARBOUR PL STE 204
MUKILTEO WA
98275-4749
US

V. Phone/Fax

Practice location:
  • Phone: 617-771-2190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60471722
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: