Healthcare Provider Details

I. General information

NPI: 1417082660
Provider Name (Legal Business Name): LISA L ROBINSON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA L ROBINSON OD

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 COTTAGE AVE STE A
CASHMERE WA
98815-1317
US

IV. Provider business mailing address

131 COTTAGE AVE STE A
CASHMERE WA
98815-1317
US

V. Phone/Fax

Practice location:
  • Phone: 509-888-5877
  • Fax:
Mailing address:
  • Phone: 509-888-5877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODP-906
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: