| Doctor Name: | LISA A MESAROS |
| NPI Number: | 1033397450 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | C0002085 |
| Business Practice Address: | 931 S Market Blvd Pmg Sw Wa Chehalis Family Medicine Chehalis, WA - 985323423 |
| Business Phone Number: | 3607676300 |
| Business Fax Number: | |
| Mailing Address: | Po Box 3360, Pmg Sw Wa PORTLAND |
| State: | OR |
| Postal Code: | 972083360 |
| Phone Number: | 8667472455 |
| Fax Number: | |
| NPI Enumeration Date: | 02/07/2008 |
| NPI Last Update Date: | 03/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | C0002085 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |