Individual
MRS. LISA MARIE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.P
Contact information
Practice address
325 E GEORGE HOPPER RD, #106, BURLINGTON, WA 98233-3154
(360) 707-2300
Mailing address
1489 JUNIPER LN, CAMANO ISLAND, WA 98282-8810
(360) 661-6583
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 00015542
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 00015542
MASSAGE PRACTITIONER LICENSE
WA
Enumeration date
01/18/2011
Last updated
06/13/2012
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