MEDICARE: LISA R GROSSMAN PHD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1114861796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LISA R GROSSMAN PHD PLLC

Provider Business Mailing Address
First Line	:	1717 W FRANCIS AVE STE 204
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-6858
Country	:	US
Telephone Number	:	509-285-1615
Fax Number	:	509-905-3638

Provider Business Practice Location Address
First Line	:	1717 W FRANCIS AVE STE 204
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-6858
Country	:	US
Telephone Number	:	509-285-1615
Fax Number	:	509-905-3638

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. LISA RUTH GROSSMAN
Credential	:	PH.D.
Telephone Number	:	509-285-1615

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	05/22/2026

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