Individual
KISHA P OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAL PEDICURIST
Contact information
Practice address
14917 AMBAUM BLVD SW, BURIEN, WA 98166-1847
(206) 501-1264
Mailing address
12520 ROOSEVELT WAY NE APT 303, SEATTLE, WA 98125-3948
(206) 501-1264
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
E2100-100167
WA
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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