DR. LISA LYA PACHECO (NPI# 1174661011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174661011 |
| Entity Type | Individual |
| Full Name | DR. LISA LYA PACHECO |
| Other Name | DR. LISA LYA LOGAN |
| Credential | DO |
| Practice Address |
805 S Reserve St Missoula MT 59801 |
| Mailing Address |
805 S Reserve St Missoula MT 59801-2104 |
| Practice Telephone | 4065496600 |
| Practice Fax Number | 4065491511 |
| Mailing Telephone | 4065496600 |
| Mailing Fax Number | 4065491511 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-08-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | 11801 | MT | Allopathic & Osteopathic Physicians |
| N | 204D00000X | Neuromusculoskeletal Medicine & OMM | 1440 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM | 031093 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225156284 | Lisa Renee Pacheco | Counselor | 6950 Hillsdale Court, Indianapolis, IN 46250-2040 | 2007-03-27 |
| Street Address |
805 S RESERVE ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588608616 | Richard Frederick John Holtzen IIi | Dentist | 805 S Reserve St, Missoula, MT 59801-2104 | 2006-06-16 |
| 1346642998 | Surgical Sleep Solutions Pllc | Oral & Maxillofacial Surgery | 805 S Reserve St, Missoula, MT 59801-2104 | 2014-09-25 |
| 1407116338 | Facial Plastic and Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2012-05-25 |
| 1134286883 | Facial Plastic & Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2007-01-02 |
| 1689745804 | Clark O Taylor | Oral & Maxillofacial Surgery | 805 S Reserve St, Missoula, MT 59801-2104 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871571364 | Christopher Thomas Caldwell | Neuromusculoskeletal Medicine & OMM | 500 W Broadway, Missoula, MT 59802 | 2006-01-04 |
| 1912133885 | Missoula Osteopathic Clinic, Pllc | Neuromusculoskeletal Medicine & OMM | 341 W Pine St, Missoula, MT 59802-4119 | 2009-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023134293 | Brian W Abbott | Neuromusculoskeletal Medicine & OMM | 3150 N Montana Ave Ste A, Helena, MT 59602 | 2007-03-21 |
| 1225466022 | Jennifer J Jamrog | Neuromusculoskeletal Medicine & OMM | 245 Windward Way Ste 101, Kalispell, MT 59901-3385 | 2013-10-15 |
| 1417059924 | Jack O Ford | Neuromusculoskeletal Medicine & OMM | 700 W Gold St, Butte, MT 59701-2320 | 2006-09-04 |
| 1902842883 | Dharma Rose | Neuromusculoskeletal Medicine & OMM | 54699 Hillside Rd, St Ignatius, MT 59865-8915 | 2006-06-21 |
| 1043299720 | Heather Mcree | Neuromusculoskeletal Medicine & OMM | 1930 9th Ave, Helena, MT 59601-4759 | 2006-01-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.