| NPI | 1689005381 |
|---|---|
| Former Name | LISA MADSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 077039614RN) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2013-12-20 |