Individual
CRISTAL BISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 S 11TH ST STE 5, COEUR D ALENE, ID 83814-4000
(208) 930-1275
Mailing address
23404 E BOONE AVE, LIBERTY LAKE, WA 99019-9560
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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