Provider Demographics
NPI:1295849040
Name:KARTIGANER, LISA E'LYN (MSW, LICSW, ACSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:E'LYN
Last Name:KARTIGANER
Suffix:
Gender:F
Credentials:MSW, LICSW, ACSW
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:E'LYN
Other - Last Name:KARTIGANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1500 LAKESIDE AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-4028
Mailing Address - Country:US
Mailing Address - Phone:206-851-4327
Mailing Address - Fax:
Practice Address - Street 1:6400 SOUTHCENTER BLVD
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2547
Practice Address - Country:US
Practice Address - Phone:206-901-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000048941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB40002Medicare ID - Type Unspecified