Individual
DR. LARISSA ELISE MANCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PY, PHD
Contact information
Practice address
2400 NE 95TH ST, SEATTLE, WA 98115-2426
(206) 525-5050
Mailing address
2400 NE 95TH ST, SEATTLE, WA 98115-2426
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60459199
WA
103TC0700X
Clinical Psychologist
Primary
PY60747612
WA
Other
Enumeration date
11/04/2014
Last updated
11/06/2020
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