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Organization

LA LUNE INTEGRATIVE PSYCHIATRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELITA WONG NP (OWNER, NURSE PRACTITIONER)
(206) 531-7844
Entity
Organization

Contact information

Practice address
522 W RIVERSIDE AVE STE 4117, SPOKANE, WA 99201-0580
(206) 531-7844
(503) 386-3252
Mailing address
522 W RIVERSIDE AVE STE 4117, SPOKANE, WA 99201-0580
(206) 531-7844
(503) 386-3252

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP61085917
STATE LICENSE
WA
Enumeration date
04/16/2022
Last updated
04/16/2022
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