Healthcare Provider Details

I. General information

NPI: 1063352656
Provider Name (Legal Business Name): LULU PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5470 SHILSHOLE AVE NW STE 405
SEATTLE WA
98107-4040
US

IV. Provider business mailing address

3031 S HOLDEN ST APT D
SEATTLE WA
98108-3959
US

V. Phone/Fax

Practice location:
  • Phone: 360-521-6951
  • Fax:
Mailing address:
  • Phone: 360-521-6951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MOLLY MCDONNELL
Title or Position: ARNP, PMHNP
Credential: MSN
Phone: 360-521-6951