Provider Demographics
NPI:1396884573
Name:WADA, LISA SCHILLING (ND)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:SCHILLING
Last Name:WADA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 118TH AVE SE
Mailing Address - Street 2:D211
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3820
Mailing Address - Country:US
Mailing Address - Phone:206-331-3771
Mailing Address - Fax:
Practice Address - Street 1:1421 NW 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5340
Practice Address - Country:US
Practice Address - Phone:206-781-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001461175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath