Basic Information
| Provider Information | |||||||||
| NPI: | 1750367454 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | R.N., ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1019 PACIFIC AVENUE #300 | ||||||||
| Address2: | COMMUNITY HEALTH CARE | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537221540 | ||||||||
| FaxNumber: | 2537221546 | ||||||||
| Practice Location | |||||||||
| Address1: | 1708 EAST 44TH STREET | ||||||||
| Address2: | COMMUNITY HEALTH CARE | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534714553 | ||||||||
| FaxNumber: | 2534745395 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2005 | ||||||||
| LastUpdateDate: | 07/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP30004011 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | MR0245755 | 01 | DEA REGISTRATION NUMBER | OTHER | 9618455 | 05 | WA | MEDICAID |