Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Liberty Lake Family & Sports Medicine, P.s.

Organization Sports Medicine (Family Medicine) Physician · NPI 1043407935

Liberty Lake Family & Sports Medicine, P.s. is a Sports Medicine (Family Medicine) Physician in Liberty Lake, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007

Practice location Address checks out

2207 N Molter Rd Ste 101
Liberty Lake, WA 99019-7571
Phone: (509) 921-7755
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 601991291 (WA)

Record details

NPI number1043407935
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Manson — Owner · (509) 921-7755
NPI enumeratedSeptember 25, 2007
Last updated in NPPESOctober 4, 2011
Mailing address2207 N Molter Rd, Ste 101, Liberty Lake, WA 99019-7571