Reardon, Lisa Marie

Reardon, Lisa Marie is an individual health care provider with primary practice located at 4008 W 27Th Ave, Suite 103 , Kennewick WA 99337. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Reardon, Lisa Marie can be contacted via phone (509) 942-2355.

Contact Information

Primary practice address
4008 W 27Th Ave, Suite 103 Kennewick WA 99337
Phone: (509) 942-2355
Fax: (509) 222-1289
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA00739 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA60423341 Washington

Profile Details

NPI number 1700049228
LBN Legal business name Reardon, Lisa Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2008
Last updated Nov 17th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700049228 NPPES
Washington MEDICAID 1700049228

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