Individual
PROF. LISA FORTLOUIS WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
16040 CHRISTENSEN RD STE 217, TUKWILA, WA 98188-2966
(206) 244-9959
Mailing address
16040 CHRISTENSEN RD STE 217, TUKWILA, WA 98188-2966
(206) 244-9959
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
WA 1504
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WA1504
STATE LICENSE NUMBER
WA
Enumeration date
01/28/2007
Last updated
07/09/2007
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