Provider Demographics
NPI:1043337850
Name:IRONS, LISA MARIE (LM P)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:IRONS
Suffix:
Gender:F
Credentials:LM P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BURNETT AVE S
Mailing Address - Street 2:SUITE 304
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-2558
Mailing Address - Country:US
Mailing Address - Phone:425-793-3697
Mailing Address - Fax:
Practice Address - Street 1:321 BURNETT AVE S
Practice Address - Street 2:SUITE 304
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-2558
Practice Address - Country:US
Practice Address - Phone:425-793-3697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA17302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA177050OtherLABOR & INDUSTRY