Individual
LISA L ILLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1959 NE PACIFIC ST., SEATTLE, WA 98195-0001
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD00001205
WA
Other
Enumeration date
02/22/2006
Last updated
09/19/2024
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