Healthcare Provider Details

I. General information

NPI: 1114861796
Provider Name (Legal Business Name): LISA R. GROSSMAN, PH.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W FRANCIS AVE STE 204
SPOKANE WA
99205-6858
US

IV. Provider business mailing address

1717 W FRANCIS AVE STE 204
SPOKANE WA
99205-6858
US

V. Phone/Fax

Practice location:
  • Phone: 509-285-1615
  • Fax: 509-905-3638
Mailing address:
  • Phone: 509-285-1615
  • Fax: 509-905-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA RUTH GROSSMAN
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 509-285-1615