Individual
MS. LISA MARIE KOHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 428-6434
(360) 848-4233
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP30007703
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30007703
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0220034
LIWA
WA
05
—
1042213
—
WA
01
—
3169FR
BSWA
WA
05
—
9652330
—
WA
Enumeration date
12/14/2005
Last updated
07/31/2015
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