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Individual

KATHLEEN ANN LELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6505 216TH ST SW STE 100, MOUNTLAKE TERRACE, WA 98043-2089
(425) 640-7009
(425) 678-6455
Mailing address
100 N HOWARD ST STE W, SPOKANE, WA 99201-0508

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
123505
CA
106H00000X
Marriage & Family Therapist
Primary
MG61648835
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123505
CALIFORNIA BOARD OF BEHAVIORAL SCIENCE
CA
Enumeration date
09/21/2021
Last updated
03/28/2025
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