Provider Demographics
NPI:1831841204
Name:MANZIONE, LISA M (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:MANZIONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:MANZIONE-PILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13613 198TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-8415
Mailing Address - Country:US
Mailing Address - Phone:425-831-7348
Mailing Address - Fax:425-831-0533
Practice Address - Street 1:13613 198TH AVE SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-8415
Practice Address - Country:US
Practice Address - Phone:425-831-7348
Practice Address - Fax:425-831-0533
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00099440163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty