Individual
DR. LISA CATHLEEN KIENEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8420 ASPI BLVD, MOSES LAKE, WA 98837-3601
(509) 793-9781
(509) 764-3281
Mailing address
660 S COOLIDGE ST, MOSES LAKE, WA 98837-1872
(097) 939-7155
(509) 764-3244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61130841
WA
207Q00000X
Family Medicine Physician
TRN27403
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2179902
—
WA
Enumeration date
06/25/2018
Last updated
08/31/2021
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