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1669534459

NPI Code Detail

MEDICARE: LISA A MOHR MD

MEDICARE: LISA A MOHR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	MD00043847	WA
2	207Q00000X	Family Medicine Physician	MD00043847	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0202532	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1669534459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A MOHR MD

Provider Business Mailing Address
First Line	:	PO BOX 84026
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-8426
Country	:	US
Telephone Number	:	206-783-3948
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 33RD AVE W
Second Line	:	STE 100
City	:	SEATTLE
State	:	WA
Zip	:	98199-3252
Country	:	US
Telephone Number	:	206-320-3364
Fax Number	:	206-320-5869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	10/08/2020

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Directions to “ LISA A MOHR MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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