Provider Demographics
NPI:1356688360
Name:WESCOTT, LILY MARTINA (MS, LMFT)
Entity Type:Individual
Prefix:MS
First Name:LILY
Middle Name:MARTINA
Last Name:WESCOTT
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 NW 197TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2332
Mailing Address - Country:US
Mailing Address - Phone:206-817-5727
Mailing Address - Fax:
Practice Address - Street 1:2017 NW 197TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-2332
Practice Address - Country:US
Practice Address - Phone:206-817-5727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60488001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist