=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437928165
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LILY WESCOTT PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2023
-----------------------------------------------------
Last Update Date | 12/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2017 NW 197TH ST
-----------------------------------------------------
City | SHORELINE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98177-2332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-817-5727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2017 NW 197TH ST
-----------------------------------------------------
City | SHORELINE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98177-2332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-817-5727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, MARRIAGE & FAMILY THERAPIST
-----------------------------------------------------
Name | LILY WESCOTT
-----------------------------------------------------
Credential | MS, LMFT
-----------------------------------------------------
Telephone | 206-817-5727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------