Provider Demographics
NPI:1477198877
Name:LINK, LISA SUSAN (MSN, RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:SUSAN
Last Name:LINK
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 172ND ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-8255
Mailing Address - Country:US
Mailing Address - Phone:425-431-7579
Mailing Address - Fax:
Practice Address - Street 1:1132 172ND ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8255
Practice Address - Country:US
Practice Address - Phone:425-431-7579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00152571163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALINKL327OtherSCHOOL DISTRICT