Individual
DIANDRA BRIGETTE KISSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
721 N PINES RD, SPOKANE VALLEY, WA 99206-5225
(509) 892-1100
Mailing address
721 S HENRY RD, GREENACRES, WA 99016-9617
(509) 953-2928
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
02/01/2024
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