Provider Demographics
NPI:1265319198
Name:BOSTIC, ELIZABETH (LMFTA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BOSTIC
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4847 YAKIMA AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-5725
Mailing Address - Country:US
Mailing Address - Phone:907-347-1481
Mailing Address - Fax:
Practice Address - Street 1:4847 YAKIMA AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-5725
Practice Address - Country:US
Practice Address - Phone:907-347-1481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist