Provider Demographics
NPI:1831295591
Name:ADAMS, LISA M
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8578
Mailing Address - Country:US
Mailing Address - Phone:425-261-1500
Mailing Address - Fax:
Practice Address - Street 1:11511 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-8578
Practice Address - Country:US
Practice Address - Phone:425-261-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2307225100000X
NC4816225100000X
WAPT00005619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0210550OtherCRIME VICTIMS
WA1170ADOtherREGENCE BS
WA1519ADOtherREGENCE BS
WA1831295591Medicaid
WA4578ADOtherREGENCE
WA0115ADOtherREGENCE
WA911745305-98053-A011OtherTRICARE
WA8359747OtherDSHS
WA911745305-98208-B033OtherTRICARE
WA5305ADOtherREGENCE
WA911745305-98275-A015OtherTRICARE
WA0239751OtherL&I
WA1020ADOtherREGENCE BS
WA2250ADOtherREGENCE BS
WA4416735OtherAETNA
WA8359747Medicaid
WA0213008OtherDEPT. OF LABOR & INDUST.
WA911745305-98026-A016OtherTRICARE
WA8944619OtherL&I CRIME VICTIMS
WA8948589OtherL&I CRIME
WA8944619OtherL&I CRIME VICTIMS
WA911745305-98275-A015OtherTRICARE
WA8359747Medicaid
WAG8892809Medicare PIN
WAG8891166Medicare PIN
WAG8875623Medicare PIN
WAG8949879Medicare PIN
WA911745305-98026-A016OtherTRICARE
WAG8862535Medicare PIN