Individual
LYSA SUSANNE WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
34515 9TH AVE S, FEDERAL WAY, WA 98003-6761
(253) 838-9700
(253) 838-6418
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00040467
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0171208
LIWA
WA
01
—
0171209
LIWA
WA
01
—
0180224
LIWA
WA
01
—
1186WA
BSWA
WA
01
—
2165WA
BSWA
WA
01
—
2217WA
BSWA
WA
05
—
8288730
—
WA
Enumeration date
06/17/2006
Last updated
02/01/2023
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