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General NPI Number Information
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NPI Number | 1912918988
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Entity Type | Individual
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Provider Name | LISA SUZANNE COWDEN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 16122 8TH AVE SW STE D2
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City | BURIEN
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State | WA
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Zip | 98166-2049
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Country | US
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Telephone | 206-241-9068
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Fax | 206-241-2651
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Provider Business Mailing Address
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Address Line | 16122 8TH AVE SW STE D2
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City | BURIEN
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State | WA
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Zip | 98166-2049
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Country | US
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Telephone | 206-241-9068
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Fax | 206-241-2651
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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 | PY1748
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License Number State | WA
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