Provider Demographics
NPI:1811314677
Name:LISA S BLISS MD PS
Entity type:Organization
Organization Name:LISA S BLISS MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-868-0938
Mailing Address - Street 1:15404 E SPRINGFIELD AVE
Mailing Address - Street 2:SUITE L201
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037
Mailing Address - Country:US
Mailing Address - Phone:509-868-0938
Mailing Address - Fax:509-892-9998
Practice Address - Street 1:15404 E SPRINGFIELD AVE
Practice Address - Street 2:SUITE L201
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037
Practice Address - Country:US
Practice Address - Phone:509-868-0938
Practice Address - Fax:509-892-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000422502081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty