Provider Demographics
NPI:1295620920
Name:LYSKO, ANASTASIYA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANASTASIYA
Middle Name:
Last Name:LYSKO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4229
Mailing Address - Country:US
Mailing Address - Phone:646-575-3139
Mailing Address - Fax:
Practice Address - Street 1:1921 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4229
Practice Address - Country:US
Practice Address - Phone:646-575-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty