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Individual

JEFFERY L LILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9001 N COUNTRY HOMES BLVD, SPOKANE, WA 99218-2072
(833) 411-5469
(855) 459-3020
Mailing address
9001 N COUNTRY HOMES BLVD, SPOKANE, WA 99218-2072
(833) 411-5469
(855) 459-3020

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-8894
ID
207R00000X
Internal Medicine Physician
Primary
MD00042522
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1040281
WA
05
806734200
ID
Enumeration date
05/23/2006
Last updated
07/06/2023
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