Doctor Name: | LISA LYNN WAUGH |
NPI Number: | 1033597778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | MC60214928 |
Business Practice Address: | 5224 Olympic Dr Nw Suite 101 Gig Harbor, WA - 983351790 |
Business Phone Number: | 3606499859 |
Business Fax Number: | |
Mailing Address: | 5224 Olympic Dr Nw, Suite 101 GIG HARBOR |
State: | WA |
Postal Code: | 983351790 |
Phone Number: | 3606499859 |
Fax Number: | |
NPI Enumeration Date: | 05/14/2015 |
NPI Last Update Date: | 05/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MC60214928 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |