Provider Demographics
NPI:1174030464
Name:LAWSON, CORNELIA ELISE (CDPT)
Entity type:Individual
Prefix:
First Name:CORNELIA
Middle Name:ELISE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 N 76TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4724
Mailing Address - Country:US
Mailing Address - Phone:509-906-1499
Mailing Address - Fax:
Practice Address - Street 1:5631 KIRKWOOD PL N UNIT C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5929
Practice Address - Country:US
Practice Address - Phone:509-906-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health