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Individual

DR. LISA P MAESTAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
12410 E SINTO AVE STE B, SPOKANE VALLEY, WA 99216-2280
(509) 838-2531
(509) 755-6580
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
(509) 755-6580
(509) 755-6580

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
OP60455816
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10013148
LOVELACE HEALTHPLAN
NM
01
2222574
FIRST HEALTH
NM
05
39626253
NM
01
881327
AHCCCS
NM
01
NM004A63
BLUESHIELD/NM
NM
Enumeration date
06/15/2005
Last updated
06/17/2014
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