Individual
RYAN WESLEY LISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1309 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-3310
(208) 933-4442
(208) 933-4273
Mailing address
531 MAGNOLIA AVE, TWIN FALLS, ID 83301-6210
(208) 244-4013
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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