Individual
DAVID IVAN KISTOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
36907 5TH AVE SW, FEDERAL WAY, WA 98023-7346
(206) 446-4740
Mailing address
36907 5TH AVE SW, FEDERAL WAY, WA 98023-7346
(206) 446-4740
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60622265
WA
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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