Individual
CHRISTYNA KIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
996 NW CIRCLE BLVD STE 101, CORVALLIS, OR 97330-1485
(541) 757-0878
(541) 757-0879
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1108
MT
225X00000X
Occupational Therapist
Primary
243593
OR
225X00000X
Occupational Therapist
60126762
WA
225X00000X
Occupational Therapist
—
ID
Other
Enumeration date
09/07/2011
Last updated
07/01/2015
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