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Individual

MR. ISSACHAR NISTRIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRST

Contact information

Practice address
3626 FACTORIA BLVD SE, BELLEVUE, WA 98006-6128
(310) 409-4277
Mailing address
5603 ELAINE AVE SE, AUBURN, WA 98092-8399

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
60736793
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6073693
REGISTRATION
WA
Enumeration date
06/28/2018
Last updated
06/28/2018
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