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Organization

MIKHAIL KISSELEV, ND, PH.D, LLC

Active
Parent organization
MIKHAIL KISSELEV, ND, PH.D, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
MIKHAIL KISSELEV, ND, PH.D, LLC
Authorized official
DR. MIKHAIL O. KISSELEV ND (MEDICAL DIRECTOR)
(206) 361-0108
Entity
Organization

Contact information

Practice address
11524 15TH AVE NE, SUITE C, SEATTLE, WA 98125-6357
(206) 361-0108
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary

Other

Enumeration date
09/24/2012
Last updated
09/24/2012
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