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Individual

LISA R KOSHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
413 LILLY RD NE, MS: 01B03, OLYMPIA, WA 98506-5133
(360) 493-4159
(360) 493-4470
Mailing address
410 PROVIDENCE LN NE, OLYMPIA, WA 98506-6927
(360) 493-4645
(360) 493-4470

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009269
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
176707
DEPT OF LABOR & INDUSTRIE
WA
01
2540KO
REGENCE BLUE SHILED
WA
01
8931101
CRIME VICTIMS
WA
05
9638875
WA
Enumeration date
07/11/2006
Last updated
07/10/2012
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