Individual
LUTRICIA LEVETTE CISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
400 UNION AVE SE STE 244, OLYMPIA, WA 98501-2060
(360) 918-7240
(360) 459-3705
Mailing address
1617 FONES RD SE TRLR 35, OLYMPIA, WA 98501-7408
(360) 999-1910
(360) 459-3705
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN60086332
WA
Other
Enumeration date
05/10/2020
Last updated
05/10/2020
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