Provider Demographics
NPI:1215089545
Name:POLINGER, LANA (MA,LMHC)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:POLINGER
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14620 SE 16TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-6805
Mailing Address - Country:US
Mailing Address - Phone:425-649-1177
Mailing Address - Fax:435-614-2668
Practice Address - Street 1:14205 SE 36TH ST
Practice Address - Street 2:131
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1596
Practice Address - Country:US
Practice Address - Phone:425-649-1177
Practice Address - Fax:425-614-2668
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA020703LH00005338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health