MEDICARE: LORI SUE FRY

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	101YM0800X	Mental Health Counselor	LH70019928	WA

General Provider Information

NPI Number	:	1801521380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI SUE FRY

Provider Business Mailing Address
First Line	:	23403 E MISSION AVE STE 100C
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-7536
Country	:	US
Telephone Number	:	509-868-5213
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 N PINES RD STE 102
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-5225
Country	:	US
Telephone Number	:	509-892-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	01/23/2026

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Directions to “ LORI SUE FRY ” Practice Location

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