Individual
KRYSTAL ANN NISSEN-ADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 HAUSSLER RD, OMAK, WA 98841-9591
(509) 826-9600
Mailing address
2 HAUSSLER RD, OMAK, WA 98841
(509) 826-9600
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00003418
WA
Other
Enumeration date
02/26/2008
Last updated
02/26/2008
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