| Lotus Behavioral Health Llc | |
|
16040 Christensen Rd Suite 209 Tukwila WA 98188-2934 | |
| (206) 328-8889 | |
| (206) 328-8884 |
| Full Name | Lotus Behavioral Health Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 16040 Christensen Rd, Tukwila, Washington |
| Authorized Official Name and Position | Theresa Lock (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2063288889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Behavioral Health Llc Po Box 84625 Seattle WA 98124-5925 Ph: (206) 328-8889 | Lotus Behavioral Health Llc 16040 Christensen Rd Suite 209 Tukwila WA 98188-2934 Ph: (206) 328-8889 |
| NPI Number | 1891095410 |
|---|---|
| Provider Enumeration Date | 10/29/2010 |
| Last Update Date | 08/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891095410 | NPI | - | NPPES |
| 2012099 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY3514 (Washington) | Primary |
| 1041C0700X | Social Worker - Clinical | LW00009478 (Washington) | Secondary |
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