Healthcare Provider Details

I. General information

NPI: 1063352722
Provider Name (Legal Business Name): LISA JIMENEZ PMHNP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE # 7941
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

522 W RIVERSIDE AVE # 7941
SPOKANE WA
99201-0580
US

V. Phone/Fax

Practice location:
  • Phone: 509-240-9688
  • Fax:
Mailing address:
  • Phone: 509-240-9688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LISA ANN JIMENEZ
Title or Position: DIRECTOR
Credential: MSN, APRN, PMHNP
Phone: 661-348-6888