Individual
KIRK N. LIESEMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3066
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
24157
NE
2080P0202X
Pediatric Cardiology Physician
Primary
7365826-1205
UT
Other
Enumeration date
05/24/2007
Last updated
01/06/2022
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