Provider Demographics
NPI:1639754393
Name:GEORGIU, LISA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:GEORGIU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9309 196TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-7952
Mailing Address - Country:US
Mailing Address - Phone:425-346-6411
Mailing Address - Fax:
Practice Address - Street 1:1750 112TH AVE NE STE A101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3782
Practice Address - Country:US
Practice Address - Phone:425-688-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61083460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist