Provider Demographics
NPI:1275216160
Name:FINNSSON, LISA (OT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:FINNSSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 N MILDRED ST STE A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-1725
Mailing Address - Country:US
Mailing Address - Phone:253-565-0438
Mailing Address - Fax:253-564-6012
Practice Address - Street 1:633 N MILDRED ST STE A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-1725
Practice Address - Country:US
Practice Address - Phone:253-565-0438
Practice Address - Fax:253-564-6012
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002271225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist