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Organization

LIGHTHOUSE INFUSIONS, PLLC

Active
Other names
Seattle Ketamine, Lighthouse Infusions
Organization subpart
No

Provider details

NPI number
Authorized official
LIANA REN CRNA, ARNP (OWNER / MEDICAL DIRECTOR)
(425) 835-2363
Entity
Organization

Contact information

Practice address
5701 NE BOTHELL WAY STE 4, KENMORE, WA 98028-9400
(425) 835-2363
(425) 368-7634
Mailing address
5701 NE BOTHELL WAY STE 4, KENMORE, WA 98028-9400
(425) 835-2363
(425) 368-7634

Taxonomy

Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QP3300X
Pain Clinic/Center

Other

Enumeration date
09/20/2024
Last updated
09/20/2024
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