Provider Demographics
NPI:1144508722
Name:LORRAINE, ELIZABETH (LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LORRAINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:LORRAINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5410 CALIFORNIA AVE SW
Mailing Address - Street 2:201
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1562
Mailing Address - Country:US
Mailing Address - Phone:206-755-2042
Mailing Address - Fax:
Practice Address - Street 1:4428 52ND PL SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3909
Practice Address - Country:US
Practice Address - Phone:206-755-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 60194309106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist