Healthcare Provider Details

I. General information

NPI: 1619019841
Provider Name (Legal Business Name): LORELIE CACERES LIGASAN M.S., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BENG C. LIGASAN M.S., LMHC

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6334 LITTLEROCK RD SW
TUMWATER WA
98512-7332
US

IV. Provider business mailing address

1600 E OLIVE ST
SEATTLE WA
98122-2735
US

V. Phone/Fax

Practice location:
  • Phone: 360-704-7590
  • Fax: 360-704-7591
Mailing address:
  • Phone: 206-302-2200
  • Fax: 206-302-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00011359
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: