Healthcare Provider Details

I. General information

NPI: 1871896449
Provider Name (Legal Business Name): LISA MARIE CROSBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA MARIE CALL ARNP

II. Dates (important events)

Enumeration Date: 12/20/2010
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST STE 950
SEATTLE WA
98104-3592
US

IV. Provider business mailing address

805 MADISON ST STE 901
SEATTLE WA
98104-1172
US

V. Phone/Fax

Practice location:
  • Phone: 206-682-5800
  • Fax: 206-233-9657
Mailing address:
  • Phone: 206-264-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP60184636
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WR1000X
TaxonomyReproductive Endocrinology/Infertility Registered Nurse
License NumberRN00079657
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: