Individual
MRS. LISA MARIE DUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 350-4010
Mailing address
PO BOX 769, COSMOPOLIS, WA 98537-0769
(360) 580-0459
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00033395
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33065255
—
CA
Enumeration date
11/04/2019
Last updated
11/04/2019
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