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General NPI Number Information
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NPI Number | 1477880201
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Entity Type | Individual
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Provider Name | LISA E WOODRICH PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2009
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Last Update Date | 04/10/2017
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Provider Practice Location Address
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Address Line | 1200 5TH AVE
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City | SEATTLE
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State | WA
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Zip | 98101-3132
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Country | US
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Telephone | 206-374-0109
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Fax |
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Provider Business Mailing Address
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Address Line | 114 24TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98112-5452
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Country | US
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Telephone | 206-374-0109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0004291
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSYC.PY.60730559
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License Number State | WA
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