Individual
LISA M GRENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
825 SE BISHOP BLVD STE 130, PULLMAN, WA 99163-5517
(509) 336-7543
Mailing address
2301 W ASHLEY AVE, SPOKANE, WA 99208-9284
(509) 921-6560
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001146
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1079596
—
WA
01
—
8267353
PROVIDER NUMBER
WA
01
—
851519
ADA NUMBER
WA
05
—
9051731
—
WA
01
—
DI00001146
WA CERTIFICATION NUMBER
WA
Enumeration date
05/29/2008
Last updated
07/09/2025
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