Provider Demographics
NPI:1356566335
Name:LENTZ, LISA EILEEN (LMP RMT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:EILEEN
Last Name:LENTZ
Suffix:
Gender:F
Credentials:LMP RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5649 UNIVERSITY WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2619
Mailing Address - Country:US
Mailing Address - Phone:206-218-8960
Mailing Address - Fax:
Practice Address - Street 1:5649 UNIVERSITY WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2619
Practice Address - Country:US
Practice Address - Phone:206-218-8960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012555225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist