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Organization

DFAS ATTN:DFASIN/JAMBF

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIRK LIESEMER (BDE SURGEON)
(253) 477-2284
Entity
Organization

Contact information

Practice address
MADIGAN ARMY MEDICAL CTR, 9040 REID STREET, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Mailing address
MADIGAN ARMY MEDICAL CTR, 9040 REID STREET, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
11/16/2015
Last updated
12/04/2015
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