Provider Demographics
NPI:1356790430
Name:HASSE, LISA MARIE HOFFMAN
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE HOFFMAN
Last Name:HASSE
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 1:1813 175TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3129
Mailing Address - Country:US
Mailing Address - Phone:425-773-2177
Mailing Address - Fax:
Practice Address - Street 1:12025 115TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6935
Practice Address - Country:US
Practice Address - Phone:425-821-1810
Practice Address - Fax:425-823-1231
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health