Healthcare Provider Details

I. General information

NPI: 1437090628
Provider Name (Legal Business Name): SANDRA RISER JR.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDY RISER

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11909 N DIVISION ST STE 102
SPOKANE WA
99218-1969
US

IV. Provider business mailing address

1018 S GARRY RD
LIBERTY LAKE WA
99019-9771
US

V. Phone/Fax

Practice location:
  • Phone: 509-319-2235
  • Fax: 509-319-2235
Mailing address:
  • Phone: 801-889-0880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: