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

Mark Lisak

Individual provider Occupational Therapy Assistant · NPI 1699600452

Mark Lisak is an Occupational Therapy Assistant in Flagstaff, Arizona. Licensed in Arizona. Registered with an NPI since 2026.

Licensed in
AZ
In the registry since
2026

Practice location Address checks out

3112 E Butler Ave
Flagstaff, AZ 86004-0009
Phone: (860) 519-7902
Fax: (502) 212-8502
Show map & directions

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

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 0047313 (AZ)

Record details

NPI number1699600452
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 15, 2026
Last updated in NPPESJune 15, 2026
Certification dateJune 15, 2026
Mailing address3112 E Butler Ave, Flagstaff, AZ 86004-0009

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