Individual
KIRSTEN ELENA WALLSKOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(530) 204-4700
Mailing address
6100 W STATE ST APT 321, WAUWATOSA, WI 53213-2990
(812) 272-0682
Taxonomy
Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
5302044700
MI
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
5302044700
MI
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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