Provider Demographics
NPI:1407814767
Name:HARRINGTON, LISE JANE (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:LISE
Middle Name:JANE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1619
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99156-1619
Mailing Address - Country:US
Mailing Address - Phone:509-996-5884
Mailing Address - Fax:509-260-2076
Practice Address - Street 1:405 W WALNUT ST STE 1
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:WA
Practice Address - Zip Code:99156-9388
Practice Address - Country:US
Practice Address - Phone:509-996-5884
Practice Address - Fax:509-260-2076
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60713118171100000X
WA60701250111N00000X
OR273034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU76210Medicare UPIN