Provider Demographics
NPI:1205224672
Name:RAWSON, LISA KRISTINA (LM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KRISTINA
Last Name:RAWSON
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 EAST RD
Mailing Address - Street 2:
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470-6300
Mailing Address - Country:US
Mailing Address - Phone:707-671-6281
Mailing Address - Fax:
Practice Address - Street 1:8700 EAST RD
Practice Address - Street 2:
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470-6300
Practice Address - Country:US
Practice Address - Phone:707-671-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife