Individual
DR. LISA NICOLE FOMENOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
14777 NE 40TH ST, SUITE 102, BELLEVUE, WA 98007-3300
(425) 883-2543
(425) 867-1109
Mailing address
14777 NE 40TH ST, SUITE 102, BELLEVUE, WA 98007-3300
(425) 883-2543
(425) 867-1109
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00034259
WA
Other
Enumeration date
08/09/2006
Last updated
01/21/2008
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