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Individual

MS. LISA C.S. ROOTVIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
7350 W DESCHUTES AVE STE A, KENNEWICK, WA 99336-7802
(509) 783-9894
(509) 737-3423
Mailing address
550 GAGE BLVD STE 101, RICHLAND, WA 99352-9532
(509) 942-3627
(509) 627-2983

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60391951
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60391951
WA
363LA2200X
Adult Health Nurse Practitioner
R190791
MD

Other

Enumeration date
07/20/2010
Last updated
02/26/2021
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