Provider Demographics
NPI:1194067447
Name:SAMUELSON, LISA K (CRT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:SAMUELSON
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:501 W INTERNATIONAL AIRPORT RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1106
Mailing Address - Country:US
Mailing Address - Phone:907-565-6100
Mailing Address - Fax:907-565-6112
Practice Address - Street 1:501 W INTERNATIONAL AIRPORT RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1106
Practice Address - Country:US
Practice Address - Phone:907-565-6100
Practice Address - Fax:907-565-6112
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified