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NPI Code Detail

MEDICARE: LISA ANNE LANDSIEDEL

MEDICARE:   LISA ANNE LANDSIEDEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker61429959WA

General Provider Information

NPI Number : 1083349377
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANNE LANDSIEDEL
Provider Business Mailing Address
First Line : 107 S DIVISION ST
Second Line :
City : SPOKANE
State : WA
Zip : 99202-1510
Country : US
Telephone Number : 509-838-4651
Fax Number :
Provider Business Practice Location Address
First Line : 4815 N ASSEMBLY ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-6185
Country : US
Telephone Number : 509-434-7767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2022
Last Update Date : 12/08/2025

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Directions to “ LISA ANNE LANDSIEDEL ” Practice Location

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