Individual
KRISHA-TYRA MISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
3900 E VALLEY RD STE 105, RENTON, WA 98057-4954
(425) 255-5532
Mailing address
13904 SE 242ND PL, KENT, WA 98042-5139
(509) 425-6227
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DENT.DE.61107478
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/01/2019
Last updated
01/29/2026
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