Provider Demographics
NPI:1548343122
Name:PUJOL BOE, LISA ALEXIUS (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ALEXIUS
Last Name:PUJOL BOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12507 NE BEL RED RD
Mailing Address - Street 2:STE 103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2500
Mailing Address - Country:US
Mailing Address - Phone:925-984-5946
Mailing Address - Fax:
Practice Address - Street 1:10620 NE 8TH ST
Practice Address - Street 2:BELLEVUE PAIN INSTITUTE
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4380
Practice Address - Country:US
Practice Address - Phone:425-999-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85353207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine