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General NPI Number Information
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NPI Number | 1023306149
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Entity Type | Organization
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Legal Business Name | POLLY LYSEN-HALPERN
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 3216 NE 45TH PL SUITE 212
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City | SEATTLE
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State | WA
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Zip | 98105-4093
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Country | US
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Telephone | 206-414-9992
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Fax | 206-452-3010
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Provider Business Mailing Address
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Address Line | 3216 NE 45TH PL SUITE 212
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City | SEATTLE
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State | WA
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Zip | 98105-4093
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Country | US
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Telephone | 206-414-9992
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Fax | 206-452-3010
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Authorized Official
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Title or Position | OWNER
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Name | MS. POLLYANN LYSEN-HALPERN
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Credential | ARNP
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Telephone | 206-414-9992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AP30003688
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License Number State | WA
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