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General NPI Number Information
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NPI Number | 1154307163
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Entity Type | Individual
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Provider Name | LISA A EASTON-HUMMEL ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 555 DAYTON ST STE A3
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City | EDMONDS
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State | WA
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Zip | 98020-3647
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Country | US
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Telephone | 425-670-3710
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Fax | 425-670-3711
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Provider Business Mailing Address
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Address Line | 555 DAYTON ST STE A3
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City | EDMONDS
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State | WA
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Zip | 98020-3647
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Country | US
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Telephone | 425-670-3710
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Fax | 425-670-3711
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP30003284
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License Number State | WA
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