Wareham, Lisa Dawn

Wareham, Lisa Dawn is an individual health care provider with primary practice located at 12715 E Mission Ave Optional, Spokane Valley WA 99201-9920. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Wareham, Lisa Dawn can be contacted via phone (253) 227-3802.

Contact Information

Primary practice address
12715 E Mission Ave Optional Spokane Valley WA 99201-9920
Phone: (253) 227-3802
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 60028558 Washington

Profile Details

NPI number 1073237806
LBN Legal business name Wareham, Lisa Dawn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2022
Last updated Sep 26th, 2022 - about 3 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 1073237806 NPPES
Washington MEDICAID 2077844

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