Individual
FNU NISINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 W ROSE ST, WALLA WALLA, WA 99362-1662
(509) 525-6650
Mailing address
1120 W ROSE ST, WALLA WALLA, WA 99362-1662
(509) 525-0247
(509) 552-2349
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7825
NV
122300000X
Dentist
Primary
DE61429179
WA
Other
Enumeration date
07/05/2023
Last updated
07/28/2023
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