DR. Lisa Nicole Fomenoff, D.C.

NPI #1194735472 in Bellevue, Washington

Provider Information

NPI Number: 1194735472
Entity Type: Individual
Name: DR. Lisa Nicole Fomenoff, D.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Aug 9, 2006
Last Updated: Jan 21, 2008

Practice Location

Address: 14777 NE 40TH ST
Address 2: SUITE 102
City: Bellevue
State: Washington
ZIP Code: 98007-3300
Phone: (425) 883-2543

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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