Individual
JEREMY KISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8532 W 4TH PL, KENNEWICK, WA 99336-9436
(509) 205-5486
Mailing address
8532 W 4TH PL, KENNEWICK, WA 99336-9436
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH 00070158
WA
Other
Enumeration date
06/16/2012
Last updated
06/16/2012
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