Provider Demographics
NPI:1841308640
Name:LOESER, LISA BETH (LMFT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:BETH
Last Name:LOESER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19507 21ST PL NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2302
Mailing Address - Country:US
Mailing Address - Phone:206-550-1051
Mailing Address - Fax:
Practice Address - Street 1:406 MAIN ST
Practice Address - Street 2:SUITE 115B
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3166
Practice Address - Country:US
Practice Address - Phone:206-550-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist