Provider Demographics
NPI:1700898350
Name:VILA, LIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LIZABETH
Middle Name:
Last Name:VILA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S. GRADY WAY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:206-394-6346
Mailing Address - Fax:425-228-2007
Practice Address - Street 1:15 S. GRADY WAY
Practice Address - Street 2:SUITE 500
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:206-394-6346
Practice Address - Fax:425-228-2007
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002369103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical