Individual
MRS. LISA ELANE MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
19217 36TH AVE W, SUITE 102, LYNNWOOD, WA 98036-5751
(425) 670-9995
Mailing address
19217 36TH AVE W, SUITE 102, LYNNWOOD, WA 98036-5751
(425) 670-9995
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT 00001157
WA
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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