Individual
KIERAN LYSSA NASHAN
Active
Individual
KIERAN LYSSA NASHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60480124
WA
225100000X
Physical Therapist
PTP-PT-LIC-9425
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942617188
—
MT
05
—
2039509
—
WA
01
—
P01476740
RR MEDICARE PTAN
WA
Enumeration date
07/21/2014
Last updated
04/25/2024
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