Healthcare Provider Details

I. General information

NPI: 1770010787
Provider Name (Legal Business Name): STEVEN CHRISTOPHER LIEBING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 GOETHALS DR STE 300
RICHLAND WA
99352-3552
US

IV. Provider business mailing address

550 GAGE BLVD STE 101
RICHLAND WA
99352-9532
US

V. Phone/Fax

Practice location:
  • Phone: 509-943-3196
  • Fax: 509-946-0455
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-627-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP61189318
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: