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NPI Code Detail

MEDICARE: DR. LISA KAREN VANDE VUSSE M.D.

MEDICARE: DR. LISA KAREN VANDE VUSSE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianMD60142363WA
2207R00000XInternal Medicine PhysicianMD60142363WA
3207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD60142363WA
4207RP1001XPulmonary Disease PhysicianMD60142363WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962508507
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA KAREN VANDE VUSSE M.D.
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number : 206-520-5700
Fax Number :
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC ST
Second Line :
City : SEATTLE
State : WA
Zip : 98195-0001
Country : US
Telephone Number : 206-520-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 12/04/2025

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