Individual
KISHA M CLUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21911 76TH AVE W STE 110, EDMONDS, WA 98026-7918
(425) 640-4950
(425) 640-4958
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD60874927
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356795363
—
WA
Enumeration date
04/15/2016
Last updated
08/05/2020
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