Individual
MISS ELAINE CATHERINE KISER-RUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1608 S J ST FL 5, TACOMA, WA 98405-4930
(253) 274-7505
(360) 830-1385
Mailing address
1608 S J ST FL 5, TACOMA, WA 98405-4930
(253) 274-7505
(360) 830-1385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60798305
WA
363AS0400X
Surgical Physician Assistant
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2108176
—
WA
01
—
OA5114
GROUP MEDICARE PTAN
TX
Enumeration date
01/13/2011
Last updated
12/04/2020
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