Vivanco, Lisa 'Lee' Ann

Vivanco, Lisa 'Lee' Ann is an individual health care provider with primary practice located at 400 S 43Rd St , Renton WA 98055-5714. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Vivanco, Lisa 'Lee' Ann can be contacted via phone (425) 228-3440.

Contact Information

Primary practice address
400 S 43Rd St Renton WA 98055-5714
Phone: (425) 228-3440
Fax: (425) 656-4214
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP60865969 Washington

Profile Details

NPI number 1871088427
LBN Legal business name Vivanco, Lisa 'Lee' Ann
Credentials DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2018
Last updated Feb 18th, 2026 - about 8 months 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 1871088427 NPPES
Washington MEDICAID 2104819

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