Provider Demographics
NPI:1144556036
Name:REDDING, LIZA (LSWAIC)
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:REDDING
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ELIZABETH
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:905 SPRUCE ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2474
Mailing Address - Country:US
Mailing Address - Phone:206-461-6935
Mailing Address - Fax:206-461-8382
Practice Address - Street 1:1930 POST ALY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1015
Practice Address - Country:US
Practice Address - Phone:206-728-4143
Practice Address - Fax:206-728-8653
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00056752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health