Provider Demographics
NPI:1336011360
Name:GANGNES, LIZABET
Entity type:Individual
Prefix:
First Name:LIZABET
Middle Name:
Last Name:GANGNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:GANGNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14241 NE WOODINVILLE DUVALL RD
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8564
Mailing Address - Country:US
Mailing Address - Phone:425-298-3238
Mailing Address - Fax:
Practice Address - Street 1:13303 NE 175TH ST STE A
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8503
Practice Address - Country:US
Practice Address - Phone:425-298-3238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health