Individual
ANDREW LISITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17885 NE EVERGREEN PARKWAY, STE 220, BEAVERTON, OR 97006
(503) 571-3366
Mailing address
603 DIVISION ST, NORTH TONAWANDA, NY 14120-4464
(716) 693-0556
(866) 907-6157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
023017
NY
225100000X
Physical Therapist
Primary
65461
OR
225100000X
Physical Therapist
PT00008783
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219769
L&I
WA
01
—
5479LI
REGENCE
WA
01
—
7587LI
REGENCE
WA
01
—
7588LI
REGENCE
WA
Enumeration date
03/28/2006
Last updated
12/04/2024
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