Healthcare Provider Details

I. General information

NPI: 1407814767
Provider Name (Legal Business Name): LISE JANE HARRINGTON D.C., L.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W WALNUT ST STE 1
NEWPORT WA
99156-9388
US

IV. Provider business mailing address

PO BOX 1619
NEWPORT WA
99156-1619
US

V. Phone/Fax

Practice location:
  • Phone: 509-996-5884
  • Fax: 509-260-2076
Mailing address:
  • Phone: 509-996-5884
  • Fax: 509-260-2076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number60713118
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number60701250
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: