Provider Demographics
NPI:1255996823
Name:DR. LISA HORSCHMAN D.D.S., PLLC
Entity type:Organization
Organization Name:DR. LISA HORSCHMAN D.D.S., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORSCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-697-5818
Mailing Address - Street 1:19365 7TH AVE NE STE 106
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7441
Mailing Address - Country:US
Mailing Address - Phone:360-697-5818
Mailing Address - Fax:
Practice Address - Street 1:19365 7TH AVE NE STE 106
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7441
Practice Address - Country:US
Practice Address - Phone:360-697-5818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1861747107OtherNPI