Individual
LISA A ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
3555 MONTE VILLA PKWY, BOTHELL, WA 98021-8982
(425) 288-2104
Mailing address
3555 MONTE VILLA PKWY, BOTHELL, WA 98021-8982
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003907
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8363061
—
WA
Enumeration date
02/06/2007
Last updated
06/21/2013
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