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Individual

MRS. LISA M UPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED. AAC

Contact information

Practice address
5301 TIETON DRIVE, SUITE C, YAKIMA, WA 98908-3478
(509) 965-7100
(509) 966-9750
Mailing address
8815 S TACOMA WAY, SUITE 122, LAKEWOOD, WA 98499-4587
(253) 682-0353
(253) 682-0301

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
RC00060345
WA
103K00000X
Behavior Analyst
Primary
1457525404
WA

Other

Enumeration date
04/21/2008
Last updated
01/13/2016
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