Frederickson, Lisa
Frederickson, Lisa is an individual health care provider with primary practice located at 508 Upland St , Kenai AK 99611-8026. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Frederickson, Lisa can be contacted via phone (907) 335-7305.Contact Information
Primary practice address
508 Upland St
Kenai AK 99611-8026
Phone: (907) 335-7305
Fax: (888) 491-3360
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3574-TX | Washington |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 199077 | Alaska |
Profile Details
| NPI number | 1972696722 |
|---|---|
| LBN Legal business name | Frederickson, Lisa |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Feb 21st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972696722 | NPPES |
| Washington | Other | 510445794 | TRIWEST |
| Washington | Other | WA-0928 | TRIWEST |
| Washington | Other | 19068 | TRIWEST |
| Washington | Other | 2030FR | TRIWEST |
| Washington | Other | 49034 | TRIWEST |
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