Healthcare Provider Details

I. General information

NPI: 1518971332
Provider Name (Legal Business Name): EDWIN LAWRENCE HILL PHD LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 SO 19TH
TACOMA WA
98405-2920
US

IV. Provider business mailing address

2013 SOUTH 19TH
TACOMA WA
98405-2920
US

V. Phone/Fax

Practice location:
  • Phone: 253-383-3355
  • Fax: 253-383-3627
Mailing address:
  • Phone: 253-383-3355
  • Fax: 253-383-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY00000984
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00000984
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: