Healthcare Provider Details

I. General information

NPI: 1164606612
Provider Name (Legal Business Name): LIZA ZILIAK LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 NE 65TH ST
SEATTLE WA
98115-6406
US

IV. Provider business mailing address

224 NE 65TH ST
SEATTLE WA
98115-6406
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-0517
  • Fax:
Mailing address:
  • Phone: 206-486-0517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberRC00052774
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60166104
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: