Provider Demographics
NPI:1780276097
Name:AZZOPARDI, LISA ANN MARIE (ND)
Entity type:Individual
Prefix:DR
First Name:LISA ANN
Middle Name:MARIE
Last Name:AZZOPARDI
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 1:1818 E 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3624
Mailing Address - Country:US
Mailing Address - Phone:510-646-5550
Mailing Address - Fax:
Practice Address - Street 1:1818 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3624
Practice Address - Country:US
Practice Address - Phone:510-646-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00000811175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00000000000OtherN/A