Active NPI
Lisa Fortlouis Wood, PH.D.
- Clinical Psychologist
- Tukwila, WA
National Provider Identifier
1972659159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- WA 1504
- Practice address
- 16040 Christensen Rd Ste 217
Tukwila, WA 98188-2966 - Phone
- (206) 244-9959
- NPI assigned
- Jan 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | WA 1504 | WA | Primary |
Addresses
Primary practice location
16040 Christensen Rd Ste 217
Tukwila, WA 98188-2966
Mailing address
16040 Christensen Rd Ste 217
Tukwila, WA 98188-2966
Phone (206) 244-9959
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WA1504 | Other | WA | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110112000224 | WA | Practitioner - Clinical Psychologist | 6709075419 | Practice locations: Seattle, WA; Tacoma, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
4505 44TH Ave SW
Seattle, WA 98116-4116
Phone (206) 244-9959
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA 1504 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1972659159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16040 CHRISTENSEN RD STE 217",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882966",
"telephone_number": "206-244-9959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16040 CHRISTENSEN RD STE 217",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882966",
"telephone_number": "206-244-9959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "LISA",
"middle_name": "FORTLOUIS",
"name_prefix": "Prof.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "WA 1504",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "WA1504",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.