Provider Demographics
NPI:1164445292
Name:VAN LOBEN SELS, LISA M (MPT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:VAN LOBEN SELS
Suffix:
Gender:F
Credentials:MPT
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Mailing Address - Street 1:11400 SE 6TH ST
Mailing Address - Street 2:STE 105
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6419
Mailing Address - Country:US
Mailing Address - Phone:425-576-8180
Mailing Address - Fax:425-746-2002
Practice Address - Street 1:10510 NORTHUP WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7901
Practice Address - Country:US
Practice Address - Phone:425-576-8180
Practice Address - Fax:425-828-7840
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00007689225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist