Individual
MRS. LISA MARIE JIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-2705
(253) 968-2252
Mailing address
207 LUMPKIN ST, FORT MOORE, GA 31905-6548
(254) 226-0826
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
04/01/2010
Last updated
05/07/2024
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