Provider Demographics
NPI:1588662530
Name:CHRISTIAN, LISA BESS (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:BESS
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 S MCCLELLAN ST
Mailing Address - Street 2:SUITE 411
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2457
Mailing Address - Country:US
Mailing Address - Phone:509-838-8168
Mailing Address - Fax:509-838-8256
Practice Address - Street 1:820 S MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2457
Practice Address - Country:US
Practice Address - Phone:509-838-8168
Practice Address - Fax:509-838-8256
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1420103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB34581Medicare ID - Type UnspecifiedPART B
WAR79465Medicare UPIN