Provider Demographics
NPI:1851349807
Name:KUNZ, LISA LB (ARNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LB
Last Name:KUNZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:611 N IRON BRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4932
Mailing Address - Country:US
Mailing Address - Phone:509-444-8888
Mailing Address - Fax:509-444-7806
Practice Address - Street 1:5901 N LIDGERWOOD ST STE 126
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1122
Practice Address - Country:US
Practice Address - Phone:509-434-1990
Practice Address - Fax:509-340-8986
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30005792363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9634023Medicaid