Provider Demographics
NPI:1891802146
Name:DURCHMAN, LIISA ELINA (MD)
Entity Type:Individual
Prefix:
First Name:LIISA
Middle Name:ELINA
Last Name:DURCHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELINA
Other - Middle Name:
Other - Last Name:DURCHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:509 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-1551
Mailing Address - Country:US
Mailing Address - Phone:206-484-7701
Mailing Address - Fax:
Practice Address - Street 1:10634 E RIVERSIDE DR STE 130
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3758
Practice Address - Country:US
Practice Address - Phone:206-934-9110
Practice Address - Fax:844-961-0333
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD600008942084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry