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Individual
LISA M ORUP-SMITH
Active
Individual
LISA M ORUP-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005141
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039585
LABOR AND INDUSTRIES#
WA
05
—
8405417
—
WA
01
—
OR5791
BLUE SHIELD #
WA
01
—
P00147310
RAILROAD MEDICARE
WA
01
—
US1051978
AETNA SPECIALIST PIN
WA
Enumeration date
02/18/2007
Last updated
04/09/2008
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