Healthcare Provider Details

I. General information

NPI: 1578450987
Provider Name (Legal Business Name): LISA MARIE SILVA GUIMARAES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-6830
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 360-947-2550
  • Fax: 360-947-2533
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11040167
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70127823-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: