Provider Demographics
NPI:1861858920
Name:TORNQUIST, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:TORNQUIST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 TORNQUIST RD
Mailing Address - Street 2:
Mailing Address - City:MCCLEARY
Mailing Address - State:WA
Mailing Address - Zip Code:98557-9504
Mailing Address - Country:US
Mailing Address - Phone:360-789-5049
Mailing Address - Fax:
Practice Address - Street 1:235 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-2255
Practice Address - Country:US
Practice Address - Phone:360-426-0890
Practice Address - Fax:360-426-4688
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60587786101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)