Individual
LISA KUMCUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
375 MT OLYMPUS DR NW, ISSAQUAH, WA 98027-3016
(425) 392-3301
(425) 392-5617
Mailing address
28850 SE 224TH ST, MAPLE VALLEY, WA 98038-7707
(206) 399-2057
(425) 413-8015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00106925
WA
3747P1801X
Personal Care Attendant
Primary
A660-400
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001CXP-12
AGING & DISABILITY SERVICES ADMINISTRATION
WA
Enumeration date
06/02/2014
Last updated
06/02/2014
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