Provider Demographics
NPI:1477820116
Name:CHOE, LISA (PHARMD, BS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:PHARMD, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20725 HIGHWAY 99
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7454
Mailing Address - Country:US
Mailing Address - Phone:425-712-1220
Mailing Address - Fax:425-712-3795
Practice Address - Street 1:20725 HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7454
Practice Address - Country:US
Practice Address - Phone:425-712-1220
Practice Address - Fax:425-712-3795
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00069813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist