Provider Demographics
NPI:1487830378
Name:SWIHART, LISA (MS, CN, CC, ICF-PCC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:SWIHART
Suffix:
Gender:F
Credentials:MS, CN, CC, ICF-PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 FARINA LOOP SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-9442
Mailing Address - Country:US
Mailing Address - Phone:206-949-1875
Mailing Address - Fax:
Practice Address - Street 1:1542 FARINA LOOP SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98513-9442
Practice Address - Country:US
Practice Address - Phone:206-949-1875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL61079147101YM0800X
WANU60039905133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No133N00000XDietary & Nutritional Service ProvidersNutritionist