Provider Demographics
NPI:1407593502
Name:HARTZER, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HARTZER
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 1:16913 N MAYFAIR DR
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9292
Mailing Address - Country:US
Mailing Address - Phone:509-847-8099
Mailing Address - Fax:
Practice Address - Street 1:16913 N MAYFAIR DR
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:WA
Practice Address - Zip Code:99005-9292
Practice Address - Country:US
Practice Address - Phone:509-847-8099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach