Provider Demographics
NPI:1851157176
Name:SHFRAWE, LISHAN
Entity Type:Individual
Prefix:
First Name:LISHAN
Middle Name:
Last Name:SHFRAWE
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 1:2811 S 102ND ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1870
Mailing Address - Country:US
Mailing Address - Phone:425-525-6800
Mailing Address - Fax:
Practice Address - Street 1:2811 S 102ND ST
Practice Address - Street 2:SUITE 220
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-1870
Practice Address - Country:US
Practice Address - Phone:425-525-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00049735164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse