Provider Demographics
NPI:1386738854
Name:RASMUSSEN, LISA MARIE (RC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:RC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:VARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RC
Mailing Address - Street 1:10319 53RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270
Mailing Address - Country:US
Mailing Address - Phone:360-653-7087
Mailing Address - Fax:
Practice Address - Street 1:20903 70TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026
Practice Address - Country:US
Practice Address - Phone:425-672-3333
Practice Address - Fax:425-712-0539
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00041570101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor