Provider Demographics
NPI:1689911174
Name:KATON, LISA ANN (ARNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:KATON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9803 53RD ST W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-1102
Mailing Address - Country:US
Mailing Address - Phone:253-380-4944
Mailing Address - Fax:
Practice Address - Street 1:9803 53RD ST W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-1102
Practice Address - Country:US
Practice Address - Phone:253-380-4944
Practice Address - Fax:833-903-0081
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60328990363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily