Individual
LISA ANNE DA COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
20508 56TH AVE W, LYNNWOOD, WA 98036-7650
(425) 678-1390
Mailing address
15914 44TH AVE W APT K304, LYNNWOOD, WA 98087-8929
(206) 931-8973
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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