Individual
TAMMY DEE LISH-WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 18TH AVE, LEWISTON, ID 83501-4047
(509) 780-9002
Mailing address
526 AIRWAY AVE, LEWISTON, ID 83501-4504
(509) 780-9002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
LMSW-44857
ID
Other
Enumeration date
07/20/2018
Last updated
07/24/2025
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