Basic Information
Provider Information
NPI: 1588651269
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRINGTON
FirstName: LISA
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9249 W LAKE CITY RD
Address2:  
City: HOUGHTON LAKE
State: MI
PostalCode: 486299602
CountryCode: US
TelephoneNumber: 9894225122
FaxNumber: 9894224378
Practice Location
Address1: 9249 W LAKE CITY RD
Address2:  
City: HOUGHTON LAKE
State: MI
PostalCode: 486299602
CountryCode: US
TelephoneNumber: 9894225122
FaxNumber: 9894224378
Other Information
ProviderEnumerationDate: 09/29/2005
LastUpdateDate: 08/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XLH012131MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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