Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | MA00012255 | WA |
NPI | 1073723482 |
---|---|
Provider Name | Lisa Braaten |
First Address | Seattle, WA 98118 |
Second Address | Everett, WA 98204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |