Provider Demographics
NPI:1578655148
Name:HAMILL, LISA V (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:V
Last Name:HAMILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5841
Mailing Address - Country:US
Mailing Address - Phone:253-759-3586
Mailing Address - Fax:253-759-5746
Practice Address - Street 1:2517 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-5841
Practice Address - Country:US
Practice Address - Phone:253-759-3586
Practice Address - Fax:253-759-5746
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine