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Individual

LISA M MASUMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 689-3138
Mailing address
255 W MICHIGAN AVE, P. O. BOX 1123, JACKSON, MI 49201-2218
(866) 570-0077
(248) 479-0652

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001188926
VA

Other

Enumeration date
02/26/2007
Last updated
07/08/2007
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