| NPI | 1851435887 |
|---|---|
| Former Name | LISA KIM BOLOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60658000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00160391) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA RN00160391) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2025-07-24 |