NPIMap

Individual provider Active NPI

Lily J Wittich, MD

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1710273057
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60404330 Issued in WA
Practice address
104 W 5TH Ave
Suite 200W
Spokane, WA 99204-4880
Phone
(509) 624-2313
Fax
(509) 459-0686
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD60404330 WA Primary

Addresses

Primary practice location

104 W 5TH Ave
Suite 200W
Spokane, WA 99204-4880

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 706-8526

Other names 1

  • Lily Jane Shipsey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151030001511 OR Practitioner - Family Practice 8729207139 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians
Wallowa County Health Care DistrictGroup PAC ID 4183537566, 26 clinicians

Practice addresses (Care Compare)

3445 Pocahontas Rd
Baker City, OR 97814-3599
Phone (541) 523-1001

3950 17TH St
Baker City, OR 97814-1300
Phone (541) 523-1001

601 Medical Pkwy
Enterprise, OR 97828-5124

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, La Grande, OR, CCN 387150
  • Heart N Home Hospice & Palliative Care Hospice, Fruitland, ID, CCN 131545
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St. Alphonsus Medical Center - Baker City Hospital, Baker City, OR, CCN 381315
  • Wallowa Memorial Hospital Hospital, Enterprise, OR, CCN 381306
  • Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wallowa County Health Care District CurrentSince Jan 1, 2026 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Sep 30, 2015 Accepting new patients
Wallowa County Health Care District Family Medicine CurrentSince Dec 30, 2025 Accepting new patients
Wallowa County Health Care District Family Medicine CurrentSince Dec 30, 2025 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

3950 17th St
Baker City, OR 97814
Phone (541) 523-1001

3950 17th St
Ste A
Baker City, OR 97814
Phone (541) 523-1001

3445 Pocahontas Rd
Baker City, OR 97814
Phone (208) 454-9181

601 Medical Pkwy
Enterprise, OR 97828
Phone (541) 426-3111

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1710273057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-706-8526",
            "fax_number": "509-459-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "address_2": "SUITE 200W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044880",
            "telephone_number": "509-624-2313",
            "fax_number": "509-459-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTICH",
        "first_name": "LILY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60404330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILY",
            "last_name": "SHIPSEY",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.