Provider Demographics
NPI:1295459253
Name:WATERS, LIANNE MARIE (RN, BSN, CCM)
Entity type:Individual
Prefix:MRS
First Name:LIANNE
Middle Name:MARIE
Last Name:WATERS
Suffix:
Gender:F
Credentials:RN, BSN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 E MT SPOKANE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-9459
Mailing Address - Country:US
Mailing Address - Phone:509-701-8283
Mailing Address - Fax:877-835-2648
Practice Address - Street 1:8808 E MT SPOKANE PARK DR
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:WA
Practice Address - Zip Code:99021-9459
Practice Address - Country:US
Practice Address - Phone:509-701-8283
Practice Address - Fax:877-835-2648
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00116153163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management