Individual
KYANN R WISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4100 SW ALASKA ST, SEATTLE, WA 98116-4527
(206) 320-3399
(206) 320-5506
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60372101
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134537491
—
WA
Enumeration date
07/30/2014
Last updated
09/07/2022
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