Individual
LISA MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
850 W. MAPLE ST., MEDICAL LAKE, WA 99022
(509) 565-4000
(509) 565-4705
Mailing address
P.O. BOX 800, MEDICAL LAKE, WA 99022
(509) 565-4000
(509) 565-4705
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY61048865
WA
103TC0700X
Clinical Psychologist
2013040148
MO
Other
Enumeration date
12/17/2013
Last updated
09/14/2022
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