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Individual

LISA DAWN WAREHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12715 E MISSION AVE, OPTIONAL, SPOKANE VALLEY, WA 99201-9920
(253) 227-3802
Mailing address
PO BOX 141106, SPOKANE VALLEY, WA 99214-1106
(509) 232-5766

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
60028558
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2077844
WA
Enumeration date
09/26/2022
Last updated
09/26/2022
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