Organization
LISA A JUNGCLAS PH D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI PETERS (OFFICE MANAGER)
(360) 734-7310
Entity
Organization
Contact information
Practice address
12 BELLWETHER WAY STE 220, BELLINGHAM, WA 98225-2914
(360) 734-7310
(360) 647-8336
Mailing address
12 BELLWETHER WAY, STE 220, BELLINGHAM, WA 98225
(360) 734-7310
(360) 647-8336
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY00002518
WA
Other
Enumeration date
09/01/2009
Last updated
11/30/2012
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