Individual
MARY LENORA DISIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4100
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD00027334
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230984
L&I
WA
05
—
1033294830
—
WA
01
—
9031
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
12/28/2012
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