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Individual

MEREDITH HANLEY LISSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6374
Mailing address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6374

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6579
AZ
363A00000X
Physician Assistant
Primary
PA60804817
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA 6579
PA LICENSE
AZ
Enumeration date
10/24/2016
Last updated
03/17/2018
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