Individual
DR. GEORGE T SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1070 BASIN ST SW, STE F, EPHRATA, WA 98823-1005
(509) 754-6131
(509) 754-9243
Mailing address
1070 BASIN ST SW, STE F, EPHRATA, WA 98823-1005
(509) 754-6131
(509) 754-9243
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1908
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0681290001
MEDICARE DME
WA
05
—
2030252
—
WA
Enumeration date
09/21/2005
Last updated
08/13/2012
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