Individual
PETER JONATHAN KIESSLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
LOCUM TENENS (MULTIPLE LOCATIONS), LAKE OSWEGO, OR 97035-5523
(503) 635-9980
Mailing address
4235 WEST BAY RD., LAKE OSWEGO, OR 97035-5523
(503) 635-9980
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
G25292
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD 10083
OR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD 10973
WA
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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