Provider Demographics
NPI:1457931453
Name:GALVAN, LISA GAIL (RN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GAIL
Last Name:GALVAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 59TH ST NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5638
Mailing Address - Country:US
Mailing Address - Phone:361-522-7185
Mailing Address - Fax:
Practice Address - Street 1:10101 59TH ST NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5638
Practice Address - Country:US
Practice Address - Phone:361-522-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60595795163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherI DO NOT HAVE