Individual
CRYSTAL H KOHISTANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS
Contact information
Practice address
335 FAIRVIEW ST, SILVERTON, OR 97381-1916
(503) 873-8686
(503) 873-8689
Mailing address
335 FAIRVIEW ST, SILVERTON, OR 97381-1916
(503) 873-8686
(503) 873-8689
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA176406
OR
Other
Enumeration date
05/05/2014
Last updated
06/18/2021
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