OrganizationActive
Liberty Lake Family & Sports Medicine, P.s.
NPI 1043407935 · Sports Medicine (Family Medicine) Physician · Liberty Lake, WA
Provider details
- NPI number
- 1043407935
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Timothy Manson, Owner(509) 921-7755
- License
- 601991291 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2207 N Molter Rd
Ste 101
Liberty Lake, WA 99019-7571
Phone: (509) 921-7755
Approximate (ZIP-level) locationGet directions
Mailing address
2207 N Molter Rd
Liberty Lake, WA 99019-7571
Registry dates
- Enumerated
- 2007-09-25
- Last updated
- 2011-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.