Provider Demographics
NPI:1659181295
Name:MARQUART, LISA (CHC, CES)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MARQUART
Suffix:
Gender:F
Credentials:CHC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 POINT EDWARDS PL
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98020-7231
Mailing Address - Country:US
Mailing Address - Phone:503-702-7308
Mailing Address - Fax:
Practice Address - Street 1:1 POINT EDWARDS PL
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:WA
Practice Address - Zip Code:98020-7231
Practice Address - Country:US
Practice Address - Phone:503-702-7308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAW51315171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach