Provider Demographics
NPI:1477726685
Name:TENNEY, LISA MARY CHRISTINA (LMP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARY CHRISTINA
Last Name:TENNEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 E ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3707
Mailing Address - Country:US
Mailing Address - Phone:360-961-0799
Mailing Address - Fax:
Practice Address - Street 1:215 W HOLLY ST STE G5
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4353
Practice Address - Country:US
Practice Address - Phone:360-961-0799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021323172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist