Provider Demographics
NPI:1740658400
Name:LISA C. TRIFILETTI
Entity type:Organization
Organization Name:LISA C. TRIFILETTI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:TRIFILETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-771-2190
Mailing Address - Street 1:19009 33RD AVE W
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19009 33RD AVE W
Practice Address - Street 2:SUITE 206
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4717
Practice Address - Country:US
Practice Address - Phone:425-741-1405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60471722251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health