Provider Demographics
NPI:1043829203
Name:HABINSKY, LIOR (ARNP)
Entity type:Individual
Prefix:
First Name:LIOR
Middle Name:
Last Name:HABINSKY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15870 1ST AVE S # 106
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1301
Mailing Address - Country:US
Mailing Address - Phone:206-242-2501
Mailing Address - Fax:
Practice Address - Street 1:15870 1ST AVE S # 106
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1301
Practice Address - Country:US
Practice Address - Phone:206-242-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61090818363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner