Individual
MR. KELLY F RISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
3020 S GRAND BLVD, SPOKANE, WA 99203
(509) 456-6917
(509) 456-5902
Mailing address
3020 S GRAND BLVD, SPOKANE, WA 99203
(509) 456-6917
(509) 456-5902
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT8428
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8332785
—
WA
Enumeration date
02/08/2007
Last updated
07/08/2007
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