Provider Demographics
NPI:1982319182
Name:RAGER, LISA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:RAGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SEELY CT
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-1334
Mailing Address - Country:US
Mailing Address - Phone:360-530-3012
Mailing Address - Fax:
Practice Address - Street 1:1330 SEELY CT
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-1334
Practice Address - Country:US
Practice Address - Phone:360-530-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60849096164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse