Individual
KYLE WILLIAM WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1227 N 205TH ST, SHORELINE, WA 98133-3214
(206) 546-2220
Mailing address
11716 GREENWOOD AVE N APT 301, SEATTLE, WA 98133-8162
(206) 349-3827
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
61205687
WA
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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