Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Lisa Cathleen Kieneker, MD

Individual provider Family Medicine Physician · NPI 1215422928

Dr. Lisa Cathleen Kieneker, MD is a Family Practice in LA Conner, Washington. Qualified in 2017, 9 years ago. Practices with Select Outpatient Services Inc, a 790-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and Washington.

Years since qualifying
9
Licensed in
FL, WA
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

528 Myrtle St
LA Conner, WA 98257
Phone: (360) 466-0107
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD61130841 (WA)
Family Medicine Physician Taxonomy 207Q00000X · Licence TRN27403 (FL)

Record details

NPI number1215422928
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 25, 2018
Last updated in NPPESJuly 8, 2026
Certification dateJuly 8, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Select Outpatient Services Inc — 790 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in LA Conner