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General NPI Number Information
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NPI Number | 1114260510
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Entity Type | Individual
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Provider Name | ALEXANDER LEE TELIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 820 S MCCLELLAN ST STE 300
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City | SPOKANE
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State | WA
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Zip | 99204-2450
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Country | US
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Telephone | 509-838-7100
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Fax | 509-227-7070
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-0421
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Country | US
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Telephone | 509-838-7100
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Fax | 509-227-7070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A154746
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License Number State | CA
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