Individual
LISA 'LEE' ANN VIVANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 228-3440
(425) 656-4214
Mailing address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 228-3440
(425) 656-4270
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60865969
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104819
—
WA
Enumeration date
06/26/2018
Last updated
02/18/2026
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