Provider Demographics
NPI:1922004878
Name:NISKA, LOIS R (DO)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:R
Last Name:NISKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:203 N WASHINGTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0254
Mailing Address - Country:US
Mailing Address - Phone:509-444-8888
Mailing Address - Fax:509-444-7806
Practice Address - Street 1:1907 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4228
Practice Address - Country:US
Practice Address - Phone:208-345-1222
Practice Address - Fax:208-345-1261
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2018-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDO-212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine