Individual
KIRSTAN POISSONNIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5615 LAKE SHORE DR, SELMA, OR 97538-9711
(360) 218-1204
Mailing address
5615 LAKE SHORE DR, SELMA, OR 97538-9711
(360) 218-1204
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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