Individual
LISA MARIE GODFREY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
206 W 1ST AVE, ELLENSBURG, WA 98926-3002
(509) 201-1616
(844) 755-6412
Mailing address
PO BOX 1533, ELLENSBURG, WA 98926-1908
(509) 856-4998
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 60253453
WA
Other
Enumeration date
05/30/2012
Last updated
12/15/2017
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