Individual provider Active NPI

Lisa Ann Kingsley, LMP

  • Specialist
  • University Place, WA
National Provider Identifier
1417283557
Registry record updated Oct 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60101493 Issued in WA
Practice address
7321 58TH Street CT W
#303
University Place, WA 98467-4723
Phone
(253) 302-6447
NPI assigned
Oct 24, 2009
Last updated
Oct 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60101493 WA Primary

Addresses

Primary practice location

7321 58TH Street CT W
#303
University Place, WA 98467-4723

Mailing address

7321 58TH Street CT W
#303
University Place, WA 98467-4723
Phone (253) 302-6447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA60101493WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1256342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256342400000",
    "number": "1417283557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7321 58TH STREET CT W",
            "address_2": "#303",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984674723",
            "telephone_number": "253-302-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7321 58TH STREET CT W",
            "address_2": "#303",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984674723",
            "telephone_number": "253-302-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSLEY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-24",
        "last_updated": "2009-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60101493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2009; 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.