Provider Demographics
NPI:1629280417
Name:LIEN, JOHN ERNEST (LMP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ERNEST
Last Name:LIEN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:ERNEST
Other - Last Name:LIEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:124 E. AUGUSTA AVE.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2479
Mailing Address - Country:US
Mailing Address - Phone:509-325-4874
Mailing Address - Fax:
Practice Address - Street 1:124 E AUGUSTA AVE.
Practice Address - Street 2:SUITE 300
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2479
Practice Address - Country:US
Practice Address - Phone:509-325-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8622172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist