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Individual

LISE MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
925 N 130TH ST, SEATTLE, WA 98133-7502
(206) 485-4364
(877) 540-0569
Mailing address
925 N 130TH ST, SEATTLE, WA 98133-7502
(206) 485-4363
(877) 540-0569

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
AP60321470
WA
261QH0100X
Health Service Clinic/Center
363LF0000X
Family Nurse Practitioner
Primary
AP60321470
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1841536729
NPI
05
2024196
WA
Enumeration date
12/20/2012
Last updated
10/20/2020
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