Provider Demographics
NPI:1407212731
Name:TU, LISA (LPN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:TU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 REID STREET,
Mailing Address - Street 2:ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1000
Mailing Address - Country:US
Mailing Address - Phone:253-968-1110
Mailing Address - Fax:
Practice Address - Street 1:9040 REID STREET,
Practice Address - Street 2:ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1000
Practice Address - Country:US
Practice Address - Phone:253-968-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP51887164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse