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Individual

MIKHAIL KISSELEV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.D., L.M.P.

Contact information

Practice address
11524 15TH AVE NE STE C, SEATTLE, WA 98125-6357
(206) 355-9740
(206) 361-0636
Mailing address
11524 15TH AVE NE STE C, SEATTLE, WA 98125-6357
(206) 355-9740
(206) 361-0636

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
NT00001520
WA
225700000X
Massage Therapist
MA00013915
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0200908
L&I
WA
Enumeration date
03/20/2007
Last updated
04/25/2014
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