Provider Demographics
NPI:1316194319
Name:HAMILTON, LISA MARIE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43335 KALIFORNSKY BEACH RD STE 27
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-8250
Mailing Address - Country:US
Mailing Address - Phone:907-260-9469
Mailing Address - Fax:907-260-9435
Practice Address - Street 1:43335 KALIFORNSKY BEACH RD STE 27
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8250
Practice Address - Country:US
Practice Address - Phone:907-260-9469
Practice Address - Fax:907-260-9435
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator