Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP60182016 | WA |
N | 363LW0102X | Nurse Practitioner - Women's Health | AP 60182016 | WA |
NPI | 1073821740 |
---|---|
Provider Name | Mrs. Lisa Marie Garcia |
First Address | Richland, WA 99352-9532 |
Second Address | Richland, WA 99352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 20/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0281423 | LABOR & INDUSTRIES (01) | WA |
1073821740 | (05) | WA |