Lisa Jo Wabinga, MA60534603

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

MA60534603 Issued in WA

Practice address

23639 126TH Ave SE
Kent, WA 98031-3701

Phone

(253) 631-3101

NPI assigned

Jan 26, 2015

Last updated

Jan 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1316337546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22907 130TH PL SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980313729",
            "telephone_number": "253-355-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23639 126TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980313701",
            "telephone_number": "253-631-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WABINGA",
        "first_name": "LISA",
        "middle_name": "JO",
        "credential": "MA60534603",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "MA60534603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Volesky
• Christopher Vondran, RC, MA, MHP
• John Huddie Voorhies Jr., PHARMD
• Emily Vosburg
• Victor Vysotsky, LMP
• Jason Kent Waddell, D.C.
• Francisca Wadhwa
• Estrellita Wagner- Villasenor
• Jennifer Wagner, LMHC, SUDPT
• Purity Waigwa

• Community Health Worker in Kent, WA
• Providers in Kent, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.