Healthcare Provider Details

I. General information

NPI: 1497675672
Provider Name (Legal Business Name): LAKE WASHINGTON THERAPEUTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 E MADISON ST STE 222
SEATTLE WA
98112-3204
US

IV. Provider business mailing address

4105 E MADISON ST STE 222
SEATTLE WA
98112-3204
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-1752
  • Fax: 206-338-6413
Mailing address:
  • Phone: 206-860-1752
  • Fax: 206-338-6413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BEVERLY EXCELL CARTWRIGHT
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 206-860-1752