Individual
DR. LISA ANN MAZZOCUT SIINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15 82ND DR STE 100, GLADSTONE, OR 97027-2550
(510) 316-4255
Mailing address
1801 W CHESTNUT AVE, YAKIMA, WA 98902-3805
(510) 316-4255
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
DO211433
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/13/2016
Last updated
01/17/2023
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