Provider Demographics
NPI:1033677562
Name:SOLARI, LISA ROSE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ROSE
Last Name:SOLARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8753 E ADOBE CIR UNIT 12
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-8355
Mailing Address - Country:US
Mailing Address - Phone:907-201-0538
Mailing Address - Fax:907-921-7559
Practice Address - Street 1:1150 S COLONY WAY STE 1
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6967
Practice Address - Country:US
Practice Address - Phone:907-201-0538
Practice Address - Fax:907-921-7559
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171100000X
AK144319171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist