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Individual

DR. EVAN JOHN LIMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1930 BLACK LAKE BLVD SW STE 102, OLYMPIA, WA 98512-5651
(360) 347-6172
Mailing address
1930 BLACK LAKE BLVD SW STE 102, OLYMPIA, WA 98512-5651
(360) 347-6172

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
RC60063415
WA
103G00000X
Clinical Neuropsychologist
PY60969939
WA
103K00000X
Behavior Analyst
103TC0700X
Clinical Psychologist
Primary
PY60969939
WA
103TC2200X
Clinical Child & Adolescent Psychologist
PY60969939
WA

Other

Enumeration date
02/17/2009
Last updated
11/04/2020
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